Correlation between Early Tumor Marker Response and Imaging Response in Patients with Advanced Hepatocellular Carcinoma Treated with Lenvatinib

Oncology. 2019;97(2):75-81. doi: 10.1159/000499715. Epub 2019 Jun 26.

Abstract

Aim: This study investigated early tumor marker response and treatment response in patients with advanced hepatocellular carcinoma (HCC) treated with lenvatinib.

Methods: Twenty patients with advanced HCC who received lenvatinib were enrolled in this retrospective study. α-Fetoprotein (AFP) and des-γ-carboxyprothrombin (DCP) levels were measured before treatment as well as 2 and 4 weeks after treatment. The objective response rate was evaluated by mRECIST at 6 weeks.

Results: The response rate was 30% (complete response/partial response/stable disease/progressive disease: n = 0/6/6/8 cases) by mRECIST. At 4 weeks, the AFP levels of 12 patients (80%) were lower than at baseline. The AFP levels of 9 patients (60%) continued decreasing from 2 weeks to 4 weeks (sustained-reduction group). In this group, the response rate was 67%. The median AFP change rate was -39% at 4 weeks. In imaging responders, the AFP change rate significantly decreased (p = 0.02). The DCP change rate had no significant correlation with imaging response. The AFP-sustained-reduction group had significantly higher adherence to lenvatinib than the non-sustained-reduction group (p = 0.02).

Conclusion: With lenvatinib therapy for HCC, the AFP levels of most patients had declined at 2 weeks, and at 4 weeks the AFP-sustained-reduction group demonstrated a higher objective response.

Keywords: Des-γ-carboxyprothrombin; Early response; Hepatocellular carcinoma; Lenvatinib; α-Fetoprotein.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Biomarkers / metabolism*
  • Biomarkers, Tumor / metabolism*
  • Carcinoma, Hepatocellular / diagnostic imaging
  • Carcinoma, Hepatocellular / drug therapy*
  • Carcinoma, Hepatocellular / metabolism
  • Chemoembolization, Therapeutic
  • Female
  • Humans
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / metabolism
  • Male
  • Middle Aged
  • Phenylurea Compounds / therapeutic use*
  • Protein Precursors / metabolism*
  • Prothrombin / metabolism*
  • Quinolines / therapeutic use*
  • Retrospective Studies
  • Treatment Outcome
  • alpha-Fetoproteins / metabolism*

Substances

  • Antineoplastic Agents
  • Biomarkers
  • Biomarkers, Tumor
  • Phenylurea Compounds
  • Protein Precursors
  • Quinolines
  • alpha-Fetoproteins
  • acarboxyprothrombin
  • Prothrombin
  • lenvatinib