The impact of lenvatinib on sarcopenia in patients with advanced unresectable hepatocellular carcinoma

Lenvatinib is a multiple receptor tyrosine kinase inhibitor (TKI) approved for first-line treatment of patients with unresectable hepatocellular carcinoma (HCC). TKI are suspected of exacerbating muscle loss in patients with cancer. In this study, we analyze the role of muscle loss in patients with...

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Published in:	Scientific reports Vol. 14; no. 1; pp. 22146 - 12
Main Authors:	Praktiknjo, Michael, Pena Solano, Ana S., Sadeghlar, Farsaneh, Welchowski, Thomas, Schmid, Matthias, Möhring, Christian, Zhou, Taotao, Mahn, Robert, Monin, Malte B., Meyer, Carsten, Feldmann, Georg, Brossart, Peter, van Beekum, Cornelius, Semaan, Alexander, Matthaei, Hanno, Manekeller, Steffen, Sprinkart, Alois M., Nowak, Sebastian, Luetkens, Julian, Kalff, Jörg C., Strassburg, Christian P., González-Carmona, Maria A.
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 27-09-2024 Nature Publishing Group Nature Portfolio
Subjects:	631/250 631/67 631/67/1059/99 692/4028 692/4028/67/1504/1610/4029 Aged Aged, 80 and over Antineoplastic Agents - adverse effects Antineoplastic Agents - therapeutic use Carcinoma, Hepatocellular - complications Carcinoma, Hepatocellular - drug therapy Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - pathology Female Hepatocellular carcinoma Humanities and Social Sciences Humans Liver cancer Liver Neoplasms - complications Liver Neoplasms - drug therapy Liver Neoplasms - mortality Liver Neoplasms - pathology Male Middle Aged multidisciplinary Musculoskeletal system Phenylurea Compounds - adverse effects Phenylurea Compounds - therapeutic use Progression-Free Survival Prophylaxis Protein Kinase Inhibitors - adverse effects Protein Kinase Inhibitors - therapeutic use Protein-tyrosine kinase receptors Quinolines - adverse effects Quinolines - therapeutic use Retrospective Studies Sarcopenia Sarcopenia - drug therapy Science Science (multidisciplinary) Skeletal muscle Survival Toxicity Tyrosine kinase inhibitors
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Summary:	Lenvatinib is a multiple receptor tyrosine kinase inhibitor (TKI) approved for first-line treatment of patients with unresectable hepatocellular carcinoma (HCC). TKI are suspected of exacerbating muscle loss in patients with cancer. In this study, we analyze the role of muscle loss in patients with advanced HCC treated with lenvatinib. This is a retrospective analysis of a real-life cohort of 25 patients with advanced HCC who were treated with lenvatinib from 2018 to March 2021 in Germany. Patients were stratified for loss of skeletal muscle area during the first three months of lenvatinib therapy. Overall survival (OS), progression-free survival (PFS) and toxicity were analyzed for all patients, especially regarding loss of muscle before and during the first three months of therapy with lenvatinib. Three months after beginning of therapy with lenvatinib, a significant reduction of muscle mass was observed in 60% of patients ( p = 0.035). Despite increase of loss of skeletal muscle, patients benefitted from lenvatinib in our cohort of patients in terms of OS and PFS and did not experience increased toxicity. Furthermore, muscle loss was not a negative predictor of survival in the univariate analysis ( p = 0.675). Patients with advanced hepatocellular carcinoma experience muscle loss with lenvatinib therapy. However, despite progressive muscle loss, patients benefit from a therapy with lenvatinib in terms of OS and PFS without increased toxicity. However, assessment and prophylaxis of skeletal muscle status should be recommended during a therapy with lenvatinib.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2045-2322 2045-2322
DOI:	10.1038/s41598-024-66766-8