Asian Journal of Research and Reports in Hepatology

Survey of Nivolumab and Lenvatinib for the Treatment of Advanced Hepatocellular Carcinoma

Mamun Al Mahtab *

Interventional Hepatology Division, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Md. Abdur Rahim

Interventional Hepatology Division, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Sheikh Mohammad Noor-E-Alam

Interventional Hepatology Division, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Dulal Chandra Das

Interventional Hepatology Division, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Faysal Ahmed

Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Tarim Mahmood

Department of Maternal and Child Health, National Institute of Preventive and Social Medicine, Bangladesh.

Tasnim Mahmud

Department of Epidemiology, North South University, Dhaka, Bangladesh.

Sheikh Mohammad Fazle Akbar

Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.

*Author to whom correspondence should be addressed.

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Abstract

Background: The most common causes of hepatocellular carcinoma are hepatitis virus infection or cirrhosis of liver. Having on sixth position among all other cancers, hepatocellular carcinoma is one of the most fast-growing prognostic cancers over the world.

Objectives: The purpose of this study is to explore the clinical efficacy and side effects of Nivolumab combined with Lenvatinib.

Materials and Methods: This retrospective, observational study was done in Department of Hepatology, Lab-aid Specialized Hospital. The study was conducted during the period of Jan 2022 to Jan 2023. The total number of patients enrolled were 48. Patients were selected by purposive method of sampling. All the patients were suffering from advanced stage hepatocellular carcinoma. The data were obtained using a structured questionnaire by face-to-face interview and utilizing hospital records. Written, informed consent was obtained from each patient.

Results: The mean age of the patients were 55.8 ± 11.2 years. Regarding gender, males were more than females, which is 58.3%. With context to etiology, Hepatitis B was the major cause for development of the disease, which is 22 (45.8%) patients had this morbidity. Regarding all the patients, it was evident that, 35% patients showed Partial Response. Objective-Response Rate (ORR) was 40% and Disease-Control Rate (DCR) was 78%. With context to HBV-positive patients, 44% patients had Partial Response; the DCR was 82%. As per the HCV-positive patients were concerned, 40%, 30% and 30% demonstrated Partial Response, Stable Disease and Progressive Disease respectively. For HCV-negative patients, the DCR came out to be 84%. 38% patients suffered from dermatitis. Secondly, Grade 1-2 fatigue was seen in 23% patients. Lastly, pneumonitis and HFSR was found in minimal patients, that is 6% and 2% respectively.

Keywords: Lenvatinib, nivolumab, immunotherapy, hepatocellular carcinoma, liver

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