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. 2022 Nov;5(11):e1613.
doi: 10.1002/cnr2.1613. Epub 2022 Mar 18.

Clinical usefulness of geriatric assessment in elderly patients with unresectable hepatocellular carcinoma receiving sorafenib or lenvatinib therapy

Shuhei Sekiguchi  1   2 , Kaoru Tsuchiya  1 , Yutaka Yasui  1 , Kento Inada  1   2 , Sakura Kirino  1   2 , Koji Yamashita  1 , Yuka Hayakawa  1   2 , Leona Osawa  1 , Mayu Higuchi  1 , Kenta Takaura  1 , Chiaki Maeyashiki  1   2 , Shun Kaneko  1   2 , Nobuharu Tamaki  1   3 , Hiroyuki Nakanishi  1 , Jun Itakura  1 , Yuka Takahashi  1 , Yasuhiro Asahina  2 , Ryuichi Okamoto  2 , Masayuki Kurosaki  1 , Namiki Izumi  1
Affiliations

Clinical usefulness of geriatric assessment in elderly patients with unresectable hepatocellular carcinoma receiving sorafenib or lenvatinib therapy

Shuhei Sekiguchi et al. Cancer Rep (Hoboken). 2022 Nov.

Abstract

Background: Therapeutic strategies for unresectable hepatocellular carcinoma (u-HCC) in geriatric patients are important for real-world practice. However, there remain no established biomarkers or therapeutic strategies regarding the best second-line agent after atezolizumab plus bevacizumab therapy.

Aim: In this study, we investigated the usefulness of modified Geriatric 8 (mG8) score in examining elderly patients (≥75 years old) with unresectable hepatocellular carcinoma (u-HCC) using sorafenib or lenvatinib as first-line therapy.

Methods and results: This study assessed 101 elderly patients with u-HCC for their mG8 score (excluding elements of age from 8 items) and classified them into 2 groups according to their mG8 score: ≥11 as the high-score group and ≤ 10 as the low-score group. Among those taking sorafenib, no significant differences were noted in overall survival (OS) and progression free survival (PFS) between low and high mG8 score groups. Only modified albumin-bilirubin (ALBI) grade (2b/3 vs. 1/2a: HR 0.34; 95% CI, 0.17-0.69; p = .0029) was significantly associated with OS. Among those taking lenvatinib, patients with a high mG8 score (n = 26) had longer survival than those with a low mG8 score (n = 10) (20.0 months vs. 7.7 months: HR 0.31, 95% CI 0.11-0.89; p = .029). Intrahepatic tumor volume (<50% vs. ≥50%: HR 16.7; 95% CI, 1.71-163; p = .016) and α-fetoprotein (AFP) (<400 vs. ≥400: HR 3.38; 95% CI 0.84-19.7; p = .031) remained significant factors independently associated with OS.

Conclusions: The mG8 score may contribute to making a decision when considering either sorafenib or lenvatinib as a treatment option for u-HCC in elderly patients.

Keywords: 1; Geriatric 8 score; hepatocellular carcinoma 2; lenvatinib 4; sorafenib 3.

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Conflict of interest statement

Kaoru Tsuchiya, Masayuki Kurosaki, and Namiki Izumi received advisory board fees and honoraria for speakers' bureau from Bayer, Eli Lilly Japan, Chugai Pharmaceutical Company, and Eisai. The Japanese Ministry of Health, Labour and Welfare had no role in the design of the study; in the collection, analysis, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

FIGURE 1
FIGURE 1
Comparison between sorafenib and lenvatinib patients in overall (A) and progression‐free survival (B)
FIGURE 2
FIGURE 2
Overall survival and progression‐free survival outcomes in all patients. (A) Kaplan–Meier estimates of overall survival by mG8 scores. (B) Kaplan–Meier estimates of progression‐free survival by mG8 scores
FIGURE 3
FIGURE 3
Overall survival and progression‐free survival outcomes in the sorafenib and lenvatinib group. (A) Kaplan–Meier estimates of overall survival in the sorafenib by mG8 scores. (B) Kaplan–Meier estimates of progression‐free survival in the sorafenib by mG8 scores. (C) Kaplan–Meier estimates of overall survival in the lenvatinib by mG8 scores. (D) Kaplan–Meier estimates of progression‐free survival in the lenvatinib by mG8 scores
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References

    1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209‐249. - PubMed
    1. Bellera CA, Rainfray M, Mathoulin‐Pelissier S, et al. Screening older cancer patients: first evaluation of the G‐8 geriatric screening tool. Ann Oncol. 2012;23(8):2166‐2172. - PubMed
    1. Ishii R, Ogawa T, Ohkoshi A, Nakanome A, Takahashi M, Katori Y. Use of the Geriatric‐8 screening tool to predict prognosis and complications in older adults with head and neck cancer: a prospective, observational study. J Geriatr Oncol. 2021;12(7):1039‐1043. - PubMed
    1. Middelburg JG, Middelburg RA, van Zwienen M, et al. Impaired geriatric 8 score is associated with worse survival after radiotherapy in older patients with cancer. Clin Oncol (R Coll Radiol). 2021;33(4):e203–e10. - PubMed
    1. van Walree IC, Scheepers E, van Huis‐Tanja L, et al. A systematic review on the association of the G8 with geriatric assessment, prognosis and course of treatment in older patients with cancer. J Geriatr Oncol. 2019;10(6):847‐858. - PubMed

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