|The following article features coverage from the ASCO Gastrointestinal Cancers Symposium 2022. Click here to read more of Cancer Therapy Advisor’s conference coverage.|
The combination of lenvatinib and transarterial chemoembolization (TACE) may be a new first-line option for patients with advanced hepatocellular carcinoma (HCC), according to researchers.
Adding TACE to lenvatinib resulted in “remarkable improvements” in overall survival (OS), progression-free survival (PFS), and overall response rate (ORR), as well as “acceptable toxicity,” said Ming Kuang, MD, PhD, of The First Affiliated Hospital of Sun Yatsen University in Guangzhou, China.
Dr Kuang presented these results, from the phase 3 LAUNCH trial (ClinicalTrials.gov Identifier: NCT03905967), at the ASCO Gastrointestinal Cancers Symposium 2022.
Lenvatinib is the most widely used targeted therapy for advanced HCC, Dr Kuang said, but greater efficacy is required for better disease control. With the LAUNCH trial, researchers set out to determine if TACE could enhance the efficacy of lenvatinib.
The trial included 338 patients with advanced HCC who were randomly assigned to lenvatinib with TACE (n=170) or without it (n=168). In the TACE arm, TACE was started 1 day after lenvatinib initiation and performed on-demand according to tumor condition and liver function. Patients were treated until curative resection, progression, death, or unacceptable toxicity.
Baseline characteristics were well balanced between the treatment arms. The median age was 54 years in the TACE arm and 56 years in the lenvatinib-alone arm (overall range, 46-64 years). Men made up 81.8% of the TACE arm and 78.6% of the lenvatinib-alone arm.
The researchers found that TACE doubled the ORR when compared with lenvatinib alone — 54.1% and 25.0%, respectively (P <.001). The disease control rate was significantly higher with TACE as well — 94.1% and 73.2%, respectively (P <.001).
Similarly, OS was significantly longer in the TACE arm. The median OS was 17.8 months for the combination and 11.5 months for lenvatinib alone (hazard ratio [HR], 0.45; 95% CI, 0.33-0.61; P <.001).
The median PFS was significantly longer with TACE than with lenvatinib alone — 10.6 months and 6.4 months, respectively (HR, 0.43; 95% CI, 0.34-0.55; P <.001). Dr Kuang noted that TACE improved PFS and OS in most subgroups.
Patients in the TACE arm experienced more frequent grade 3/4 ALT increase (P <.001), AST increase (P <.001), and hyperbilirubinemia (P =.014). However, Dr Kuang said these adverse events disappeared within 2 weeks after treatment. There were no treatment-related deaths in either arm.
Based on these results, Dr Kuang concluded that lenvatinib plus TACE “may represent a potential new first-line treatment option for patients with advanced HCC.”
Disclosures: The study authors reported no conflicts of interest.
Read more of Cancer Therapy Advisor’s coverage of ASCO GI 2022 by visiting the conference page.
Peng Z, Fan W, Zhu B, et al. Lenvatinib combined with transarterial chemoembolization as first-line treatment of advanced hepatocellular carcinoma: A phase 3, multicenter, randomized controlled trial. Presented at ASCO GI 2022; January 20-22, 2022. Abstract 380.