Abstract 216P
Background
A multicenter phase II trial evaluating the efficacy of preoperative lenvatinib therapy (LENS-HCC trial) demonstrated the safety and feasibility of lenvatinib therapy followed by surgical resection. We report 3-year follow-up data on patients enrolled in the LENS-HCC trial.
Methods
Forty-eight patients with advanced hepatocellular carcinoma (HCC) and factors suggestive of a poor prognosis (macroscopic vascular invasion, extrahepatic metastasis, or multinodular tumors) were included in the study. Patients with these factors, even with technically resectable HCC, were defined as oncologically unresectable because of the expected poor prognosis. After 8 weeks of lenvatinib therapy, the patients were assessed for resectability, and tumor resection was performed in 33 patients. This study investigated overall survival, details of recurrence, and treatment for recurrence three years after the last patient enrolment in the LENS-HCC trial.
Results
The 3-year survival rate for patients who underwent surgery was 66.5%, and a median survival time (MST) was not reached, while the 3-year survival rate for patients who did not undergo surgery was 14.4%, and MST was 10.1 months (P<0.001). The 3-year survival rate for 41 cases judged as being oncologically unresectable was 53.7%, with a MST of 45.1 months, while for the others that were judged as being technically unresectable, the 3-year survival rate was 34.3%, with a MST of 24.1 months (P=0.28). Twenty-five cases had recurrence after resection (recurrence rate 75.8%); 15 cases had intrahepatic-only recurrence, 2 had lung-only recurrence, and 8 had recurrence in other organs. Systemic therapy was the most common treatment for recurrence (12 cases), followed by transcatheter arterial chemoembolization in 5 cases, surgery in 4 cases, radiofrequency ablation in 3 cases, and best supportive care in 1. At the time of the survey, 13 patients were alive without cancer.
Conclusions
Even in patients with HCC accompanied by factors suggestive of a poor prognosis, the long-term outcomes of patients who underwent lenvatinib therapy followed by surgical resection were relatively favorable.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.