Real-World Effectiveness of Sorafenib versus Lenvatinib Combined with PD-1 Inhibitors in Unresectable Hepatocellular Carcinoma

• Published in: Cancers Vol. 15; no. 3; p. 854
• Main Authors: Chiang, Hsueh-Chien, Lee, Yang-Cheng, Chang, Ting-Tsung, Lin, Yih-Jyh, Wu, Hung-Tsung, Wang, Chung-Teng, Chen, Chiung-Yu, Chen, Po-Jun, Hsieh, Ming-Tsung, Lin, Sheng-Hsiang, Chen, Shang-Hung, Chuang, Chiao-Hsiung, Wu, I-Chin, Hong, Tzu-Chun, Wu, Juei-Seng, Han, Meng-Zhi, Chen, Wei-Ting, Chiang, Chien-Ming, Hung, Kuan-Kai, Kuo, Hsin-Yu
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30.01.2023; MDPI
• Subjects: Antigens; Apoptosis; Cancer therapies; Cell death; Chemotherapy, Combination; Clinical trials; Cytotoxicity; Disease; Disease control; Dosage and administration; Drug dosages; Drug therapy; Hepatocellular carcinoma; Hepatoma; Immune checkpoint inhibitors; Immunotherapy; Liver cancer; Medical prognosis; Methods; Monoclonal antibodies; Multivariate analysis; Patient outcomes; Patients; PD-1 protein; Protein-tyrosine kinase; Tumors; Variables; Vascular endothelial growth factor; Taiwan; immune checkpoint inhibitor; lenvatinib; sorafenib; hepatocellular carcinoma
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers15030854

Immune checkpoint inhibitors (ICIs) combined with multitarget tyrosine kinase inhibitors (MTKIs) exert a synergistic effect and are effective in unresectable hepatocellular carcinoma (uHCC). However, precise data regarding the real-world clinical applications of these combination therapies in uHCC are lacking. This study compared the treatment efficacy of sorafenib versus lenvatinib in combination with programmed cell death protein-1 (PD-1) inhibitors in patients with uHCC in a clinical setting. Among 208 patients with uHCC treated with PD-1 inhibitors, 88 were administered with ICIs in combination with sorafenib or lenvatinib. The treatment response and survival outcomes were evaluated. Predictors of survival were assessed by multivariate analysis. A total of 49 patients were treated with PD-1 inhibitors combined with sorafenib, and 39 patients were treated with PD-1 inhibitors combined with lenvatinib. The lenvatinib group exhibited a stronger objective response rate (ORR) (20.51% vs. 16.33%) and had a higher disease control rate (41.03% vs. 28.57%) than did the sorafenib group. The median overall survival was longer in the lenvatinib group than the sorafenib group (13.1 vs. 7.8 months; hazard ratio = 0.39, = 0.017). The incidence of treatment-related adverse events was similar. PD-1 inhibitors combined with lenvatinib can be a feasible treatment strategy for HCC patients receiving MTKI-based combination therapy. PD-1 inhibitors combined with lenvatinib resulted in more favorable survival outcomes without increased toxic effects compared with PD-1 inhibitors with sorafenib. Additional larger-scale and prospective studies should be conducted to verify the study results.