Second-line therapy for advanced hepatocellular carcinoma with regorafenib or cabozantinib:Multicenter French clinical experience in real-life after matching  

作　　者：Xavier Adhoute Marie De Matharel Laurent Mineur Guillaume Pénaranda Dann Ouizeman Clemence Toullec Albert Tran Paul Castellani Armelle Rollet Valérie Oules HervéPerrier Si Nafa Si Ahmed Marc Bourliere Rodolphe Anty 

机构地区：[1]Department of Gastroenterology and Hepatology,Hôpital Saint-Joseph,Marseille 13000,France [2]Department of Gastroenterology and Hepatology,Hôpital Universitaire de l’Archet,Nice 06000,France [3]Department of Oncology,Institut Sainte-Catherine,Avignon 84000,France [4]Department of Biostatistics,AlphaBio Laboratory,Marseille 13000,France

出　　处：《World Journal of Gastrointestinal Oncology》2022年第8期1510-1527,共18页世界胃肠肿瘤学杂志（英文版）（电子版）

摘　　要：BACKGROUND Starting a second-line systemic treatment for hepatocellular carcinoma(HCC)is a common situation.The only therapeutic options in France are two broadspectrum tyrosine kinase inhibitors(TKIs),regorafenib(REG)and cabozantinib(CBZ),but no comparative real-life studies are available.AIM To evaluate the progression-free survival(PFS)of patients treated with REG or CBZ,we investigated the disease control rate(DCR),overall survival(OS),and safety of both drugs.To identify the variables associated with disease progression over time.METHODS A retrospective multicenter study was performed on the clinical data of patients attending one of three referral centers(Avignon,Marseille,and Nice)between January 2017 and March 2021 using propensity score matching.PFS and OS were assessed using the Kaplan-Meier method.Multivariate analysis(MA)of progression risk factors over time was performed in matched-pair groups.RESULTS Fifty-eight patients 68(62-74)years old with HCC,Barcelona clinic liver cancer(BCLC)B/C(86%),Child-Pugh(CP)-A/B(24%)received REG for 3.4(1.4-10.5)mo as second-line therapy.Twentyeight patients 68(60-73)years,BCLC B/C(75%),CP-A/B(25%)received CBZ for 3.7(1.8-4.9)mo after first-line treatment with sorafenib[3(2-4)(CBZ)vs 4(2.9-11.8)mo(REG),P=0.0226].Twenty percent of patients received third-line therapy.After matching,PFS and DCR were not significantly different after a median follow-up of 6.2(2.7-11.7)mo(REG)vs 5.2(4-7.2)mo(CBZ),P=0.6925.There was no difference in grade 3/4 toxicities,dose reductions,or interruptions.The OS of CP-A patients was 8.3(5.2-24.8)vs 4.9(1.6-11.7)mo(CP-B),P=0.0468.The MA of risk factors for progression over time identified C-reactive protein(CRP)>10 mg/L,neutrophil-to-lymphocyte ratio(NLR)>3,and aspartate aminotransferase(AST)>45 IU as predictive factors.CONCLUSION This multicenter indirect comparative study found no significant difference in PFS between REG and CBZ as second-line therapy for advanced HCC.Elevated levels of inflammatory markers(CRP and NLR)and AST were associat

关 键 词：Hepatocellular carcinoma REGORAFENIB Cabozantinib C-reactive protein Neutrophillymphocyte ratio 

分 类 号：R735.7[医药卫生—肿瘤]