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Lenvatinib After Immunotherapy for Advanced Hepatocellular Carcinoma

By: Vanessa A. Carter, BS
Posted: Friday, February 17, 2023

A retrospective study performed by Jennifer Gile, MD, of the Mayo Clinic, Rochester, Minnesota, and colleagues studied the clinical outcomes of patients with advanced hepatocellular carcinoma who received lenvatinib after immunotherapy. The results, presented during the 2023 American Society of Clinical Oncology (ASCO) GI Cancers Symposium (Abstract 507), indicated the median overall survival was comparable to that of first-line lenvatinib therapy.

“The optimal sequencing of therapy for patients with advanced hepatocellular carcinoma following [disease] progression on immunotherapy remains unknown,” the authors mentioned. “Our experience demonstrates that patients may benefit from treatment with lenvatinib following initial [disease] progression on immunotherapy.”

This multicenter study focused on 53 patients with advanced hepatocellular carcinoma who were diagnosed at the Mayo Clinic in Minnesota, Florida, and Arizona, and who received lenvatinib after immunotherapy. The median age at the start of lenvatinib treatment was 67, and most patients were male (83%). Approximately 79% and 58% of participants had a Child-Pugh score of A at diagnosis and lenvatinib initiation, respectively. Lenvatinib was administered as a second-line therapy in 85% of patients and as a third-line or later therapy in 15%. Since 38 patients died at the time of data retrieval, the corresponding median progression-free survival and overall survival were 4 and 13 months, respectively.

Fatigue, aspartate transaminase and bilirubin elevation, diarrhea, hypertension, and anorexia were the most common adverse events. Grade 3 or higher events affected 40% of patients, with confusion and hypertension among the most frequently reported. Adverse events such as fatigue, confusion, hypertension, elevated bilirubin, and heart failure led to treatment discontinuation in various patients.

Disclosure: Dr. Gile reported no conflicts of interest. For full disclosures of the other study authors, visit

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