HCC me outside.

Top Line: Can any drug successfully challenge sorafenib in the systemic treatment of hepatocellular carcinoma (HCC)?
The Study: Sorafenib, an inhibitor of multiple kinases including VEGF and BRAF, has reigned supreme in the treatment of unresectable HCC for almost a decade. Drug after drug has failed to meet its (pretty pitiful) survival advantage of <3 months over placebo alone. Enter lenvatinib, a new VEGF inhibitor. A huge study published this month in the Lancet spanning pretty much the whole globe randomized a remarkable almost 1K patients to lenvatinib versus sorafenib. Median overall survival times were 13 versus 12 months, respectively, meeting the predefined threshold for non-inferiority. What’s more, progression free survival was significantly better with lenvatinib at approximately 9 months versus 4 months with sorafenib. Side effects came in different flavors, but overall rates of any toxicity were similar. So is there an inherent benefit to lenvatinib? Not that we can tell, other than finally adding some market competition to the HCC drug game.
Bottom Line: When compared to sorafenib, lenvatinib was non-inferior in extending life and was superior in extending life free of disease among patients with unresectable HCC.


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