Impact of Lenvatinib Outcome in Patients of' Hepatocellular Carcinoma

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, with limited treatment options for advanced-stage disease. Lenvatinib, a multi-kinase inhibitor, has emerged as an effective first-line systemic therapy, demonstrating promising clinical outcomes in large international trials. However, real-world data in Pakistani population is lacking. Objective: This study aimed to evaluate the clinical efficacy and disease control outcomes of lenvatinib monotherapy in patients with advanced HCC treated at a tertiary care center in Pakistan. Methods: A descriptive case series was conducted at the Department of Medical Oncology, Hameed Latif Hospital, Lahore, including 94 patients with advanced HCC diagnosed based on clinical and radiological criteria. The study was conducted during January to June, 2025. Patients received weight-based lenvatinib therapy (12 mg or 8 mg daily), and treatment response was assessed using the modified RECIST criteria via imaging. Data were analyzed using SPSS version 27, with frequencies, percentages, and chi-square tests applied where relevant. Results: The mean age of patients was 58.4 ± 9.7 years, with 68.1% being male. Hepatitis C was the most common underlying etiology (60.6%), followed by hepatitis B (39.4%). Common comorbidities included hypertension (44.7%) and diabetes mellitus (41.5%). Treatment response showed a complete response in 6.4%, partial response in 29.8%, stable disease in 37.2%, and progressive disease in 26.6% of patients. The objective response rate (ORR) was 24.1%, and the disease control rate (DCR) was 73.4%, consistent with outcomes reported in global trials. Lenvatinib was well tolerated, with no treatment-related deaths observed. Conclusion: Lenvatinib demonstrated clinically meaningful efficacy in terms of tumor response and disease control among patients with advanced HCC in a real-world setting. These findings support its continued use as a first-line treatment and highlight the importance of individualized patient assessment to optimize therapeutic outcomes.