Real-World Data for Lenvatinib in Hepatocellular Carcinoma (ELEVATOR): A Retrospective Multicenter Study

Area of Science:

• Hepatocellular Carcinoma Research
• Oncology Drug Efficacy Studies
• Real-World Evidence in Cancer Treatment

Background:

• Lenvatinib is an approved first-line treatment for advanced hepatocellular carcinoma (HCC).
• Real-world efficacy data for lenvatinib in Caucasian populations remains limited.
• The ELEVATOR study aimed to assess lenvatinib's effectiveness in a multi-center German and Austrian cohort.

Purpose of the Study:

• To evaluate the real-world efficacy of first-line lenvatinib in advanced HCC patients.
• To compare outcomes in patients meeting and not meeting REFLECT study criteria.
• To identify prognostic factors influencing lenvatinib treatment outcomes.

Main Methods:

• Retrospective analysis of 205 patients receiving first-line systemic lenvatinib.
• Assessment of overall survival (OS), progression-free survival (PFS), and response rates.
• Evaluation of adverse event rates and prognostic factors including ALBI grade, ECOG status, macrovascular invasion, and AFP levels.

Main Results:

• Median OS was 12.8 months, comparable to the REFLECT study.
• Patients meeting REFLECT criteria showed superior mOS (15.6 vs 10.2 months) and mPFS (8.1 vs 4.8 months).
• Impaired liver function (ALBI grade), poor performance status (ECOG ≥2), macrovascular invasion, and high AFP levels were associated with shorter survival.

Conclusions:

• Lenvatinib demonstrates efficacy in a real-world Caucasian cohort for advanced HCC.
• No new safety concerns were identified, supporting lenvatinib as a viable alternative to IO-based combinations.
• Treatment outcomes are influenced by baseline patient characteristics and disease factors.