Cabozantinib (CAB) causes a high incidence of adverse events in unresectable hepatocellular carcinoma (u-HCC) and requires dose adjustments. We evaluated the efficacy and safety of the 7-on/7-off regimen composed of 7 consecutive days’ administration of CAB followed by a 7-day rest period. This was a retrospective analysis of 35 patients with u-HCC, who were treated with CAB in a multicenter cohort in Japan from 2020 to 2024. The clinical outcomes of 12 patients treated with the 7-on/7-off regimen and 23 patients treated with daily dosing were compared. There were significant differences in overall survival (12.4 months vs. 6.3 months,p= 0.03), median progression-free survival (4.8 months vs. 3.2 months,p< 0.01), objective response rate (16.7% vs. 0.0%,p= 0.04), and incidence of any adverse events (75.0% vs. 100.0%,p= 0.03) between the 7-on/7-off regimen group and daily dosing group. The median duration of drug exposure (122 days vs. 42 days,p< 0.01) and median duration of dose reduction (100 days vs. 23 days,p< 0.01) were prolonged significantly in the 7-on/7-off group than in the daily dosing group. CAB in a 7-on/7-off regimen may improve the tolerability and treatment response in patients with u-HCC.
卡博替尼（CAB）在不可切除肝细胞癌（u-HCC）治疗中不良反应发生率较高，常需调整剂量。本研究评估了“7天给药/7天停药”方案（即连续给药7天后停药7天）的疗效与安全性。该回顾性分析纳入2020年至2024年日本多中心队列中接受CAB治疗的35例u-HCC患者，比较其中12例采用7天给药/7天停药方案与23例采用每日给药方案患者的临床结局。结果显示，与每日给药组相比，7天给药/7天停药组在总生存期（12.4个月 vs. 6.3个月，p=0.03）、中位无进展生存期（4.8个月 vs. 3.2个月，p<0.01）、客观缓解率（16.7% vs. 0.0%，p=0.04）及任何级别不良反应发生率（75.0% vs. 100.0%，p=0.03）方面均存在显著差异。7天给药/7天停药组的中位药物暴露时间（122天 vs. 42天，p<0.01）与中位剂量降低持续时间（100天 vs. 23天，p<0.01）均显著长于每日给药组。采用7天给药/7天停药方案的CAB治疗可能改善u-HCC患者的治疗耐受性与治疗反应。
Optimizing Cabozantinib Dosing in Unresectable Hepatocellular Carcinoma of 7-on/7-off Regimen
肿瘤(癌症)患者之家