Adjuvant Lenvatinib Prevents Recurrence of High-risk Patients With HBV-related HCC After Liver Transplantation

High-risk patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) suffer from a high ratio of recurrence after liver transplantation (LT). Lenvatinib, as a novel targeted drug, has shown an excellent effect in the treatment of advanced HCC, but there is no study on its effect in preventing HCC recurrence in the patients undergoing transplantation. Therefore, to evaluate the role of adjuvant lenvatinib in preventing recurrence of high-risk LT recipients with HBV-related HCC, the investigators retrospectively analyzed 23 high-risk patients consisting of lenvatinib group (n=14) and control group (n=9) with HBV-related HCC who underwent LT. Disease-free survival (DFS) and HCC recurrence of the two groups were compared. The adverse events (AEs) and drug tolerance of lenvatinib were evaluated.

Sex

All

Minimum age

8 Years

Maximum age

69 Years

Inclusion Criteria:

1. The recipients who underwent liver transplantation with the pathologic diagnosis of hepatocellular carcinoma.
2. The extrahepatic metastasis was excluded preoperatively.
3. The patients were defined as "high-risk" for recurrence according to the following criteria:

(1) beyond Milan criteria confirmed either by radiology before LT or by pathology after LT, (2) tumor with intrahepatic vascular invasion, (3) Alpha-fetoprotein (AFP)≥400ng/L before LT, (4) presence of microvascular invasion (MVI), (5) tumor with histological poor differentiation according to Edmondson-Steiner classification system(21), (6) multiple satellite lesions around the largest tumors detected either by radiology before LT or by histology after LT, (7) tumor penetrating hepatic capsule, (8) recurrent HCC after resection. 4. ECOG score between 0-1 within 1 week before took lenvatinib. 5. The patients have received regular antiviral treatment. 6. Life expectancy more than 3 months.

Exclusion Criteria:

1. The patients took lenvatinib before liver transplantation and assessed as SD or PD according to the mRECIST criteria.
2. The patients suffered from other incurable malignancies within 5 years or at the same time.
3. Distant metastasis of tumor was confirmed by imaging before or within 1 month after transplantation.
4. The patients have not received regular antiviral treatment.
5. The patients had a history of mental illness or abuse of psychoactive drugs.
6. The patients deemed unsuitable by attending doctors.

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