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Title: Dose Intensity/Body Surface Area Ratio is a Novel Marker Useful for Predicting Response to Lenvatinib against Hepatocellular Carcinoma
Authors: Eso, Yuji  kyouindb  KAKEN_id  orcid (unconfirmed)
Nakano, Shigeharu
Mishima, Masako
Arasawa, Soichi
Iguchi, Eriko
Nakamura, Fumiyasu
Takeda, Haruhiko
Takai, Atsushi  kyouindb  KAKEN_id
Takahashi, Ken  kyouindb  KAKEN_id
Taura, Kojiro  kyouindb  KAKEN_id
Seno, Hiroshi  kyouindb  KAKEN_id
Author's alias: 恵荘, 裕嗣
三嶋, 眞紗子
荒澤, 壮一
中村, 文保
竹田, 治彦
髙井, 淳
高橋, 健
田浦, 康二朗
妹尾, 浩
Keywords: ALBI grade
body surface area
dose intensity
hepatocellular carcinoma
molecular-targeted therapy
relative dose intensity
Issue Date: 22-Dec-2019
Publisher: MDPI AG
Journal title: Cancers
Volume: 12
Issue: 1
Thesis number: 49
Abstract: Lenvatinib was recently approved as a novel first-line molecular targeted agent (MTA) for treating hepatocellular carcinoma (HCC). The importance of relative dose intensity (RDI) has been shown in the treatment of various types of cancers. However, RDI may not accurately reflect the treatment intensity of lenvatinib, as it is the first oral MTA where the dose is based on the patient’s weight. We aimed to evaluate the utility of 2M-DBR (the delivered dose intensity/body surface area ratio at 60 days) by comparing the relationship between 2M-DBR, 2M-RDI (RDI at 60 days), and the therapeutic response. The therapeutic response to lenvatinib was evaluated in 45 patients who underwent computed tomography 8–12 weeks after treatment initiation. We also investigated the clinical factors associated with high 2M-DBR. The area under the receiver operating characteristic of 2M-DBR that predicts the response to lenvatinib was higher than that of 2M-RDI (0.8004 vs. 0.7778). Patients with high 2M-DBR achieved significantly better objective responses and disease control rates than those with low 2M-DBR (p < 0.0001 and 0.0008). Patients with high 2M-DBR experienced significantly longer progression-free survival (PFS) than those with low 2M-DBR (p = 0.0001), while there was no significant correlation between 2M-RDI levels and PFS (p = 0.2198). Patients who achieved higher levels of 2M-DBR had a significantly better modified ALBI grade (p = 0.0437), better CONUT score (p = 0.0222), and higher BTR (p = 0.0281). Multivariate analysis revealed that high 2M-DBR was the only significant factor associated with longer PFS. In conclusion, 2M-DBR could be an important factor that reflects treatment intensity and useful for predicting the response to lenvatinib against HCC, instead of 2M-RDI.
Rights: ©2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (
DOI(Published Version): 10.3390/cancers12010049
PubMed ID: 31877859
Appears in Collections:Journal Articles

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