文章：

乐伐替尼对代谢功能障碍相关脂肪性肝炎及酒精性病因相关的肝细胞癌患者均具有显著疗效：一项倾向性评分分析

Lenvatinib Is Highly Effective in Patients with Hepatocellular Carcinoma Related to Both Metabolic Dysfunction-Associated Steatohepatitis and Alcoholic Etiology: A Propensity Score Analysis

原文发布日期：28 May 2025

DOI: 10.3390/cancers17111808

类型: Article

开放获取: 是

英文摘要：

Background and aims:Metabolic dysfunction-associated steatotic liver disease (MASLD)-related hepatocellular carcinoma (HCC) may have distinct biological characteristics influencing systemic treatment response. However, the prognostic impact of MASLD vs. alcohol-related HCC in patients receiving lenvatinib remains unclear. This study aimed to assess lenvatinib’s effectiveness and safety in these populations.Methods:A multicenter cohort of 378 HCC patients treated with lenvatinib (2019–2024) was analyzed. Propensity score matching was performed based on age, sex, tumoral stage, alpha-fetoprotein levels and Child–Pugh class. Survival was estimated using Kaplan–Meier analysis and compared with the log-rank test. Results were expressed as HR and 95% CI.Results:After matching, 115 patients per group were compared. Median OS was 21 months (95% CI: 20–23) in the group with metabolic dysfunction-associated steatohepatitis (MASH) and 19 months (95% CI: 18–21) in the group with alcohol etiology (p= 0.18). In multivariate analysis, only Child–Pugh class (HR 2.67, 95% CI: 1.84–5.41) and tumor stage (HR 2.18, 95% CI: 1.57–6.93) resulted as significant predictors of OS. Median PFS was 9 months (95% CI: 8–9) in patients with MASH and 9 months (95% CI: 7–10) in patients with alcohol etiology (p= 0.33). Only the Child–Pugh class was a significant predictor of PFS in univariate analysis (HR 1.56, 95% CI: 1.15–3.41;p= 0.03). No difference in terms of adverse event rate was observed between the two groups.Conclusions:Lenvatinib is effective in patients with both MASH- and alcohol-related HCC, with no difference in oncological outcomes between the two groups.

摘要翻译： 

**背景与目的：** 代谢功能障碍相关脂肪性肝病（MASLD）相关的肝细胞癌（HCC）可能具有独特的生物学特征，影响全身治疗反应。然而，在接受仑伐替尼治疗的患者中，MASLD相关HCC与酒精相关HCC的预后差异尚不明确。本研究旨在评估仑伐替尼在这两类人群中的有效性和安全性。 **方法：** 对2019年至2024年间接受仑伐替尼治疗的378例HCC患者的多中心队列进行分析。根据年龄、性别、肿瘤分期、甲胎蛋白水平和Child–Pugh分级进行倾向评分匹配。采用Kaplan–Meier法估计生存率，并通过Log-rank检验进行比较。结果以风险比（HR）及95%置信区间（CI）表示。 **结果：** 匹配后，每组各115例患者进行比较。代谢功能障碍相关脂肪性肝炎（MASH）组的中位总生存期（OS）为21个月（95% CI：20–23），酒精病因组为19个月（95% CI：18–21）（p=0.18）。多变量分析显示，仅Child–Pugh分级（HR 2.67，95% CI：1.84–5.41）和肿瘤分期（HR 2.18，95% CI：1.57–6.93）是OS的显著预测因素。MASH组的中位无进展生存期（PFS）为9个月（95% CI：8–9），酒精病因组为9个月（95% CI：7–10）（p=0.33）。单变量分析中，仅Child–Pugh分级是PFS的显著预测因素（HR 1.56，95% CI：1.15–3.41；p=0.03）。两组间不良事件发生率无显著差异。 **结论：** 仑伐替尼对MASH相关和酒精相关HCC患者均有效，两组间的肿瘤学结局无显著差异。

原文链接：

Lenvatinib Is Highly Effective in Patients with Hepatocellular Carcinoma Related to Both Metabolic Dysfunction-Associated Steatohepatitis and Alcoholic Etiology: A Propensity Score Analysis