Changes in Body Composition Predict the Time to Treatment Failure of Lenvatinib in Patients with Advanced Hepatocellular Carcinoma: A Pilot Retrospective Study

ABSTRACT:

Aim

Changes in body composition parameters are important prognostic factors in hepatocellular carcinoma (HCC) treatment. This study aimed to assess the clinical impact of early changes in body composition during lenvatinib (LEN) treatment on its time to treatment failure (TTF) for patients with advanced HCC.

Methods

In this retrospective study, we enrolled 65 patients who were administered LEN as the first-line treatment for unresectable HCC and evaluated the body composition change using computed tomography. We focused on the body composition change after 2 weeks of LEN treatment and assessed its impact on TTF and prognosis.

Results

Significant changes in body composition were observed during 14 weeks of LEN treatment. Among these changes, mean-skeletal muscle attenuation (SMA) decreased significantly within 2 weeks (P = 0.004) without symptoms or changes in the other parameters. In multivariate analysis, this early change in mean-SMA after LEN treatment was a significant predictor of time to treatment failure (HR: 2.67, 95%CI: 1.338–5.081, P = 0.005) in patients with HCC.

Conclusions

This study revealed that LEN treatment induces a change in the skeletal muscle asymptomatically for a short period, and evaluation of this change may help to predict the TTF of LEN treatment in patients with HCC.

Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2022.2049322 .

Acknowledgements

We acknowledge all those who contributed to the collection of cases. English language support was provided by Wiley Editing Services (https://wileyeditingservices.com/en/).

Authors’ Contributions

Concept and study design: T. Yamamoto and N. Imai; Acquisition of data: T. Yamamoto, N. Imai, T. Kuzuya, K. Yamamoto, T. Ito, Y. Ishizu, T. Honda, and M. Ishigami, Writing manuscript: T. Yamamoto and N. Imai. Statistical analysis: T. Yamamoto and N. Imai.

Disclosure Statement

T. Kuzuya: Honoraria from Bayer, Chugai, Eisai, Eli Lilly Japan. Research funding from Eisai

Funding

The author(s) reported there is no funding associated with the work featured in this article.