Lenvatinib Exacerbates the Decrease in Skeletal Muscle Mass in Patients with Hepatocellular Carcinoma, Whereas...

Area of Science:

• Hepatocellular Carcinoma Research
• Oncology Therapeutics
• Body Composition Analysis

Background:

• Hepatocellular carcinoma (HCC) treatments impact patient body composition and biomarkers.
• Skeletal muscle index (SMI) is a potential prognostic factor in cancer patients.
• Understanding treatment-related changes in adipose tissue and tumor markers is vital.

Purpose of the Study:

• To evaluate chronological changes in SMI, adipose tissue indices (SATI, VATI), AFP, PIVKA-II, and ALBI scores during atezolizumab plus bevacizumab (AB) or lenvatinib (LEN) therapy for HCC.
• To determine the effect of these changes on patient survival.
• To identify predictors for survival and changes in SMI during treatment.

Main Methods:

• Analysis of 94 HCC patients (37 on AB, 57 on LEN) with measurements at treatment introduction, 3 months, end of treatment, and last observation.
• Utilized Wilcoxon paired test for chronological change analysis.
• Employed Cox proportional hazards model and analysis of covariance to identify independent predictors for survival and SMI changes.

Main Results:

• SMI was maintained with AB treatment but significantly decreased with LEN treatment.
• SMI, AFP, and ALBI score were independent predictors of survival.
• Drug choice (AB vs. LEN) and PIVKA-II were independent predictors for SMI changes.

Conclusions:

• Atezolizumab plus bevacizumab (AB) is superior to lenvatinib (LEN) in maintaining skeletal muscle index (SMI) during hepatocellular carcinoma (HCC) treatment.
• Maintaining SMI is a critical factor for improving survival outcomes in HCC patients.
• Body composition changes and specific biomarkers should be monitored during HCC therapy.