Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination Therapy
ABSTRACT Aim We investigated the impact of proteinuria on the therapeutic effect before lenvatinib administration as second‐line treatment after atezolizumab‐bevacizumab. Methods We examined 64 patients who were administered lenvatinib as second‐line treatment after discontinuation of atezolizumab a...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.70098 |
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| author | Hironori Ochi Masayuki Kurosaki Takaaki Tanaka Nobuharu Tamaki Kaoru Tsuchiya Yutaka Yasui Hiroyuki Marusawa Toshifumi Tada Shinichiro Nakamura Takehiro Akahane Eisuke Okamoto Haruhiko Kobashi Hirotaka Arai Michiko Nonogi Namiki Izumi |
| author_facet | Hironori Ochi Masayuki Kurosaki Takaaki Tanaka Nobuharu Tamaki Kaoru Tsuchiya Yutaka Yasui Hiroyuki Marusawa Toshifumi Tada Shinichiro Nakamura Takehiro Akahane Eisuke Okamoto Haruhiko Kobashi Hirotaka Arai Michiko Nonogi Namiki Izumi |
| author_sort | Hironori Ochi |
| collection | DOAJ |
| description | ABSTRACT Aim We investigated the impact of proteinuria on the therapeutic effect before lenvatinib administration as second‐line treatment after atezolizumab‐bevacizumab. Methods We examined 64 patients who were administered lenvatinib as second‐line treatment after discontinuation of atezolizumab and bevacizumab. Proteinuria assessed before lenvatinib administration was considered severe if the qualitative value test (QV) was 3+ or the urine protein/creatinine ratio (UPCR) was ≥ 2.0 (group A, n = 13) and non‐severe if the UPCR was < 2.0 or the QV was ≤ 2+ (group B, n = 51). Results In the entire cohort, the modified albumin–bilirubin grades were grades 1, 2a, 2b, and 3 in 12, 21, 26, and 5 patients, respectively. Regarding the Barcelona Clinic of Liver Cancer stage, 2, 22, and 40 patients had stages A, B, and C, respectively. The objective response rate (ORR) was 14.0% and the disease control rate (DCR) was 59.3%. The median survival time and progression free survival after administration of lenvatinib was 14.8 (95% confidence interval [CI], 11.3–18.4) and 5.5 (95% CI, 3.6–7.5) months, respectively. The ORR and DCR were 0% and 38.4% for group A (n = 13) and 17.6% and 64.7% for group B (n = 51), respectively. The median time to treatment failure was 2.2 months in group A and 4.2 months in group B (p = 0.120). Conclusions Severe proteinuria before lenvatinib as a second‐line therapy after atezolizumab‐bevacizumab treatment may affect the duration of lenvatinib administration and treatment efficacy. |
| format | Article |
| id | doaj-art-f63456ec468b49ae95e314cd31f7e7be |
| institution | Kabale University |
| issn | 2397-9070 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj-art-f63456ec468b49ae95e314cd31f7e7be2025-01-28T09:24:32ZengWileyJGH Open2397-90702025-01-0191n/an/a10.1002/jgh3.70098Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination TherapyHironori Ochi0Masayuki Kurosaki1Takaaki Tanaka2Nobuharu Tamaki3Kaoru Tsuchiya4Yutaka Yasui5Hiroyuki Marusawa6Toshifumi Tada7Shinichiro Nakamura8Takehiro Akahane9Eisuke Okamoto10Haruhiko Kobashi11Hirotaka Arai12Michiko Nonogi13Namiki Izumi14Center for Liver‐Biliary‐Pancreatic Disease, Matsuyama Red Cross Hospital Ehime JapanDepartment of Gastroenterology and Hepatology Musashino Red Cross Hospital Tokyo JapanCenter for Liver‐Biliary‐Pancreatic Disease, Matsuyama Red Cross Hospital Ehime JapanDepartment of Gastroenterology and Hepatology Musashino Red Cross Hospital Tokyo JapanDepartment of Gastroenterology and Hepatology Musashino Red Cross Hospital Tokyo JapanDepartment of Gastroenterology and Hepatology Musashino Red Cross Hospital Tokyo JapanDepartment of Gastroenterology and Hepatology Osaka Red Cross Hospital Osaka JapanDepartment of Internal Medicine Himeji Red Cross Hospital Hyogo JapanDepartment of Internal Medicine Himeji Red Cross Hospital Hyogo JapanDepartment of Gastroenterology Ishinomaki Red Cross Hospital Miyagi JapanDepartment of Gastroenterology Masuda Red Cross Hospital Shimane JapanDepartment of Gastroenterology Japanese Red Cross Okayama Hospital Okayama JapanDepartment of Gastroenterology Maebashi Red Cross Hospital Gunma JapanDepartment of Gastroenterology Tokushima Red Cross Hospital Tokushima JapanDepartment of Gastroenterology and Hepatology Musashino Red Cross Hospital Tokyo JapanABSTRACT Aim We investigated the impact of proteinuria on the therapeutic effect before lenvatinib administration as second‐line treatment after atezolizumab‐bevacizumab. Methods We examined 64 patients who were administered lenvatinib as second‐line treatment after discontinuation of atezolizumab and bevacizumab. Proteinuria assessed before lenvatinib administration was considered severe if the qualitative value test (QV) was 3+ or the urine protein/creatinine ratio (UPCR) was ≥ 2.0 (group A, n = 13) and non‐severe if the UPCR was < 2.0 or the QV was ≤ 2+ (group B, n = 51). Results In the entire cohort, the modified albumin–bilirubin grades were grades 1, 2a, 2b, and 3 in 12, 21, 26, and 5 patients, respectively. Regarding the Barcelona Clinic of Liver Cancer stage, 2, 22, and 40 patients had stages A, B, and C, respectively. The objective response rate (ORR) was 14.0% and the disease control rate (DCR) was 59.3%. The median survival time and progression free survival after administration of lenvatinib was 14.8 (95% confidence interval [CI], 11.3–18.4) and 5.5 (95% CI, 3.6–7.5) months, respectively. The ORR and DCR were 0% and 38.4% for group A (n = 13) and 17.6% and 64.7% for group B (n = 51), respectively. The median time to treatment failure was 2.2 months in group A and 4.2 months in group B (p = 0.120). Conclusions Severe proteinuria before lenvatinib as a second‐line therapy after atezolizumab‐bevacizumab treatment may affect the duration of lenvatinib administration and treatment efficacy.https://doi.org/10.1002/jgh3.70098atezolizumab‐bevacizumabhepatocellular carcinomalenvatinibproteinuria |
| spellingShingle | Hironori Ochi Masayuki Kurosaki Takaaki Tanaka Nobuharu Tamaki Kaoru Tsuchiya Yutaka Yasui Hiroyuki Marusawa Toshifumi Tada Shinichiro Nakamura Takehiro Akahane Eisuke Okamoto Haruhiko Kobashi Hirotaka Arai Michiko Nonogi Namiki Izumi Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination Therapy JGH Open atezolizumab‐bevacizumab hepatocellular carcinoma lenvatinib proteinuria |
| title | Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination Therapy |
| title_full | Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination Therapy |
| title_fullStr | Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination Therapy |
| title_full_unstemmed | Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination Therapy |
| title_short | Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination Therapy |
| title_sort | effect of proteinuria before lenvatinib administration on treatment response after atezolizumab bevacizumab combination therapy |
| topic | atezolizumab‐bevacizumab hepatocellular carcinoma lenvatinib proteinuria |
| url | https://doi.org/10.1002/jgh3.70098 |
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