The impact of lenvatinib on sarcopenia in patients with advanced unresectable hepatocellular carcinoma

• Published in: Scientific reports Vol. 14; no. 1; pp. 22146 - 12
• Main Authors: Praktiknjo, Michael, Pena Solano, Ana S., Sadeghlar, Farsaneh, Welchowski, Thomas, Schmid, Matthias, Möhring, Christian, Zhou, Taotao, Mahn, Robert, Monin, Malte B., Meyer, Carsten, Feldmann, Georg, Brossart, Peter, van Beekum, Cornelius, Semaan, Alexander, Matthaei, Hanno, Manekeller, Steffen, Sprinkart, Alois M., Nowak, Sebastian, Luetkens, Julian, Kalff, Jörg C., Strassburg, Christian P., González-Carmona, Maria A.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 27.09.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 631/250; 631/67; 631/67/1059/99; 692/4028; 692/4028/67/1504/1610/4029; Aged; Aged, 80 and over; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Female; Hepatocellular carcinoma; Humanities and Social Sciences; Humans; Liver cancer; Liver Neoplasms - complications; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Male; Middle Aged; multidisciplinary; Musculoskeletal system; Phenylurea Compounds - adverse effects; Phenylurea Compounds - therapeutic use; Progression-Free Survival; Prophylaxis; Protein Kinase Inhibitors - adverse effects; Protein Kinase Inhibitors - therapeutic use; Protein-tyrosine kinase receptors; Quinolines - adverse effects; Quinolines - therapeutic use; Retrospective Studies; Sarcopenia; Sarcopenia - drug therapy; Science; Science (multidisciplinary); Skeletal muscle; Survival; Toxicity; Tyrosine kinase inhibitors
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-66766-8

Lenvatinib is a multiple receptor tyrosine kinase inhibitor (TKI) approved for first-line treatment of patients with unresectable hepatocellular carcinoma (HCC). TKI are suspected of exacerbating muscle loss in patients with cancer. In this study, we analyze the role of muscle loss in patients with advanced HCC treated with lenvatinib. This is a retrospective analysis of a real-life cohort of 25 patients with advanced HCC who were treated with lenvatinib from 2018 to March 2021 in Germany. Patients were stratified for loss of skeletal muscle area during the first three months of lenvatinib therapy. Overall survival (OS), progression-free survival (PFS) and toxicity were analyzed for all patients, especially regarding loss of muscle before and during the first three months of therapy with lenvatinib. Three months after beginning of therapy with lenvatinib, a significant reduction of muscle mass was observed in 60% of patients ( p  = 0.035). Despite increase of loss of skeletal muscle, patients benefitted from lenvatinib in our cohort of patients in terms of OS and PFS and did not experience increased toxicity. Furthermore, muscle loss was not a negative predictor of survival in the univariate analysis ( p  = 0.675). Patients with advanced hepatocellular carcinoma experience muscle loss with lenvatinib therapy. However, despite progressive muscle loss, patients benefit from a therapy with lenvatinib in terms of OS and PFS without increased toxicity. However, assessment and prophylaxis of skeletal muscle status should be recommended during a therapy with lenvatinib.