Comparative Outcome Analysis of Lenvatinib Versus Sorafenib for Recurrence of Hepatocellular Carcinoma After Liver Transplantation
Christian T. J. Magyar, Sheron Perera, Luckshi Rajendran, Zhihao Li, Fahad A. Almugbel, Sophie Feng, Woo Jin Choi, Laia Aceituno, Arndt Vogel, Robert C. Grant, Nazia Selzner, Elmar Jaeckel, Nazanin Falla-Rad, Jennifer J. Knox, Eric X. Chen, Gonzalo Sapisochin, Grainne M. O’KaneBackground.
Hepatocellular carcinoma (HCC) recurs after liver transplantation (LT) in ~17% of patients. We aimed to retrospectively compare the outcomes of patients treated with different tyrosine kinase inhibitors (TKIs) for recurrent HCC post-LT.
Methods.
Patients with recurrent HCC post-LT between 2006 and 2019 were included. The impact of sorafenib and lenvatinib treatment for recurrent disease was assessed using survival analysis with an a priori multivariable Cox regression (alpha-fetoprotein [AFP] at recurrence, recurrence lesion diameter, single-site versus multisite metastases).
Results.
Seven hundred fifty-four patients underwent LT for HCC, of whom 120 (15.9%) developed recurrence. Of these patients, 56 received TKIs: sorafenib (n = 42) or lenvatinib (n = 14). The median age at LT was 60.8 y (interquartile range, 54.0–66.2); 52 (93%) were men and 26 (46%) were within Milan criteria at listing. Baseline characteristics at recurrence were comparable between the 2 groups, including largest tumor diameter (
Conclusions.
Our findings suggest lenvatinib is a valuable treatment option for patients with HCC recurrence after LT.