Balancing Efficacy With Toxicity Among the Agents for HCC

Balancing Efficacy With Toxicity Among the Agents for HCC
Catherine Frenette, MD

Published Online:Nov 29, 2018

Catherine Frenette, MD: The 2 groups of lenvatinib [Lenvima] versus sorafenib [Nexavar] in the REFLECT trial were not stratified by AFP [alpha-fetoprotein] level. They were also not stratified by their underlying cause of liver disease. The patients in the lenvatinib group did have a slightly higher AFP than the patients in the sorafenib group. This may actually have resulted in a favorable imbalance in the positive for sorafenib. Additionally, hepatitis C patients were more frequent in the sorafenib group as compared with the lenvatinib group. This may have given a benefit to sorafenib. The reason for this discussion is that we recall, in the SHARP trial, when they broke out a subgroup of patients who were treated with sorafenib and had hepatitis C, had quite a longer median survival. In the SHARP trial, the overall survival [OS] in the subgroup was 10.7 months. In the hepatitis C–treated population with sorafenib, there may have been a longer OS than would have been seen in patients who were stratified for that risk factor.....

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https://www.targetedonc.com/case-based-peer-perspectives/hepatocellular-carcinoma/frenette-unresectable-hcc/balancing-efficacy-with-toxicity-among-the-agents-for-hcc