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

<b>Background and aims:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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 (<i>p</i> = 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 (<i>p</i> = 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; <i>p</i> = 0.03). No difference in terms of adverse event rate was observed between the two groups. <b>Conclusions:</b> Lenvatinib is effective in patients with both MASH- and alcohol-related HCC, with no difference in oncological outcomes between the two groups.

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Journal
Cancers
Published
2025-05-28
DOI
https://doi.org/10.3390/cancers17111808
Citations
2
Primary Topic
Liver Disease Diagnosis and Treatment
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article
Field-Weighted Citation Impact
2.71
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article

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

Filomena Morisco, Paolo Gallo, Luca Rinaldi, Luca Giacomelli et al.
2 citations
Cancers
Liver Disease Diagnosis and Treatment
2.71
article

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

Filomena Morisco, Paolo Gallo, Luca Rinaldi, Luca Giacomelli, Antonio Facciorusso, Adriano Pellicelli, Edoardo G. Giannini, Massimo Bellini, Caterina Cocuzza, Giuseppe Cabibbo, Andrea Pasta, Umberto Vespasiani‐Gentilucci, Piera Federico, Rodolfo Sacco, Raffaella Tortora, Andrea Mega, Maurizio Russello, Giulia Pieri, Bruno Daniele, Luca Marzi, Ernesto Claar, Marianna Silletta, Andrea Casadei‐Gardini, Concetta Tatali, Giovan Giuseppe Di Costanzo, Marco Di Stefano, Antonio Izzi, Valeria Pace Palitti
article en
2 citations

Abstract

<b>Background and aims:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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 (<i>p</i> = 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 (<i>p</i> = 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; <i>p</i> = 0.03). No difference in terms of adverse event rate was observed between the two groups. <b>Conclusions:</b> Lenvatinib is effective in patients with both MASH- and alcohol-related HCC, with no difference in oncological outcomes between the two groups.

CancersVol. 17(11)
University of Foggia (IT), University of Pisa (IT), University of Molise (IT), University of Salento (IT), Vita-Salute San Raffaele University (IT), Ospedale di Bolzano (IT), Ospedale Garibaldi (IT), Fatebenefratelli Hospital (IT), Villa Pineta Hospital (IT), Campus Bio Medico University Hospital (IT), Ospedale Policlinico San Martino (IT), Azienda USL di Pescara (IT), Ospedale D. Cotugno (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Ospedali Riuniti Umberto I (IT), University of Naples Federico II (IT), University of Palermo (IT)
Openalex Percentile: Top 10%
Liver Disease Diagnosis and Treatment
2.71
DOIOpen Access PDFOpenAlex
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