The beneficial impact of metabolic dysfunction‐associated fatty liver disease on lenvatinib treatment in patients with non‐viral hepatocellular carcinoma

• DOI: 10.1111/hepr.13843
• Publication Date: 2022-09-23T15:33:38Z
• Authors: Shigeo Shimose; Atsushi Hiraoka; Andrea Casadei‐Ga...; Tsubasa Tsutsumi; Dan Nakano; Hideki Iwamoto; Fujimasa Tada; Margherita Rimini; Masatoshi Tanaka; Takuji Torimura; Hideya Suga; Hideko Ohama; Valentina Burgio; Takashi Niizeki; Etsuko Moriyama; Hiroyuki Suzuki; Tomotake Shirono; Yu Noda; Naoki Kamachi; Masahito Nakano; Ryoko Kuromatsu; Hironori Koga; Takumi Kawaguchi
• Keywords: 0301 basic medicine; 03 medical and health sciences; 3. Good health

AbstractAimLenvatinib is used to treat advanced hepatocellular carcinoma (HCC). Metabolic dysfunction‐associated fatty liver disease (MAFLD) is becoming a major etiology of HCC. We aimed to evaluate the impact of MAFLD on the efficacy of lenvatinib.MethodsWe enrolled 320 patients with HCC who were treated with lenvatinib. All patients were classified into the MAFLD (n = 155) and non‐MAFLD (n = 165) groups. Independent factors for overall survival (OS) were analyzed. In the stratification analysis, HCC was categorized as non‐viral (n = 115) or viral HCC (n = 205).ResultsThe OS rate was significantly higher in the MAFLD group than in the non‐MAFLD group (median 21.1 vs. 15.1 months, p = 0.002). Multivariate analysis demonstrated that, in addition to albumin‐bilirubin grade and Barcelona Clinic Liver Cancer stage, MAFLD was identified as an independent factor for OS (HR 0.722, 95% CI 0.539–0.966, p = 0.028). In the stratification analysis, the OS rate was significantly higher in the MAFLD group than in the non‐MAFLD group among patients with non‐viral HCC (median 21.1 vs. 15.1 months, p = 0.002), but not in patients with viral HCC. Furthermore, MAFLD was an independent negative risk factor for OS in patients with non‐viral HCC (HR 0.506, 95% CI 0.297–0.864, P < 0.01). However, MAFLD was not an independent factor for OS in patients with viral HCC.ConclusionsMAFLD was a beneficial factor for survival in patients with HCC treated with lenvatinib. Moreover, the better OS of the MAFLD group was more pronounced in patients with non‐viral HCC. Lenvatinib may be a suitable agent for patients with non‐viral HCC and MAFLD.