Factors Contributing to the Prognosis after Second-line Therapy with Ramucirumab in Advanced Hepatocellular Carcinoma
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- Sugimoto Rie
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Japan
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- Motomura Kenta
- Department of Hepatology, Aso Iizuka Hospital, Japan
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- Ooho Aritsune
- Department of Hepatology, Steel Memorial Yawata Hospital, Japan
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- Aratake Yoshifusa
- Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Japan
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- Ueda Akihiro
- Department of Internal Medicine, Fukuoka City Hospital, Japan
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- Senju Takeshi
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Japan
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- Tanaka Yuki
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Japan
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- Yada Masayoshi
- Department of Hepatology, Aso Iizuka Hospital, Japan
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- Tanaka Kohsuke
- Department of Hepatology, Aso Iizuka Hospital, Japan
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- Kuwano Akifumi
- Department of Hepatology, Aso Iizuka Hospital, Japan
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- Morita Yuusuke
- Department of Hepatology, Aso Iizuka Hospital, Japan
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- Nagasawa Shigehiro
- Department of Hepatology, Aso Iizuka Hospital, Japan
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- Ooe Mari
- Department of Hepatology, Steel Memorial Yawata Hospital, Japan
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- Mutsuki Taiji
- Department of Hepatology, Steel Memorial Yawata Hospital, Japan
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- Yoshimoto Tsuyoshi
- Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Japan
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- Yamashita Naoki
- Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Japan
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- Nakashima Mai
- Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Japan
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- Hioki Tomonobu
- Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Japan
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- Koyanagi Toshimasa
- Department of Internal Medicine, Fukuoka City Hospital, Japan
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- Higuchi Nobito
- Department of Internal Medicine, Fukuoka City Hospital, Japan
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- Nakamura Tsukasa
- Department of Internal Medicine, Fukuoka City Hospital, Japan
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- Harada Shigeru
- Department of Gastroenterology, Chihaya Hospital, Japan
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- Tanaka Masatake
- Department of Medicine and Bioregulatory Science, Kyushu University, Japan
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- Tada Seiya
- Department of Gastroenterology and Hepatology, Fukuokahigashi Medical Center, Japan
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- Satoh Takeaki
- Department of Center for Liver Disease, Kokura Medical Center, Japan
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- Uchimura Koutarou
- Department of Internal Medicine, Social Insurance Nakabaru Hospital, Japan
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- Kuniyoshi Masami
- Department of Gastroenterology, Kyushu Rosai Hospital, Japan
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- Nakamuta Makoto
- Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Japan
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- Kohjima Motoyuki
- Department of Medicine and Bioregulatory Science, Kyushu University, Japan
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説明
<p>Objective Multiple therapeutic agents exist for advanced hepatocellular carcinoma (HCC), but prognostic factors in second-line and subsequent therapies are unclear. Ramucirumab is a molecular-targeted agent effective against hepatocytes with alpha-fetoprotein (AFP) >400 ng/mL after sorafenib failure. We examined the prognostic factors and efficacy of ramucirumab with prior therapy other than sorafenib. </p><p>Methods In our retrospective multicenter study, 33 patients were treated with ramucirumab for HCC with prior therapy other than sorafenib, including 1 patient who received 2 lines of ramucirumab. We analyzed background factors, liver reserve, the prognosis, and treatment duration and efficacy. </p><p>Results The median albumin-bilirubin (ALBI) value showed little change during ramucirumab treatment. The ALBI value improved in 32% of patients, and their prognoses were better than in those who did not improve. Response and efficacy rates were not as high as those in the REACH-2 study but were similar when limited to patients with 2,500 ng/mL AFP. Thirteen patients received further treatment after ramucirumab failure and they had a significantly better prognosis from ramucirumab administration and also had a significantly better prognosis from the start of the first tyrosine kinase inhibitor than who did not received further treatment. In univariate and multivariate analyses of prognostic factors, the continuation of treatment with another drug after ramucirumab failure and a good ALBI value at initiation were significant. The presence of a ramucirumab response and treatment duration were not associated with the prognosis. A good ALBI value at initiation and ALBI value improvement during treatment were also identified as independent factors associated with eligibility for further treatment after ramucirumab failure. The treatment line did not correlate with the availability of treatment with another drug after treatment failure. </p><p>Conclusions ALBI value improvement with ramucirumab treatment allows for subsequent treatment after failure and an improved overall prognosis. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 61 (21), 3157-3164, 2022-11-01
一般社団法人 日本内科学会