Early impact of lenvatinib on liver function and its prognostic significance: a single-center retrospective study

OBJECTIVE: Lenvatinib shows efficacy for tumor response and survival in patients with advanced hepatocellular carcinoma (HCC). We aim to assess the effect of lenvatinib on liver function. METHODS: This single-center retrospective cohort study included 40 patients with advanced HCC who received ≥ 2 months of lenvatinib treatment from January 2020 to January 2024 and had at least one efficacy and safety assessment. RESULTS: The ALBI score showed a slight but significant increase of 0.112 points, from -2.517 at baseline to -2.405 following 2-month of treatment (P < 0.05). With a median follow-up of 18.5 months, the median overall survival was 22.8 months (95% CI: 16.3-29.3), and the median progression-free survival was 12.7 months (95% CI: 9.1-16.3). Both COX regression and Kaplan-Meier analyses indicated that impaired baseline liver function was associated with adverse clinical outcomes. Additionally, treatment response emerged as an independent prognostic factor. CONCLUSIONS: The baseline ALBI score serves as a key prognostic marker, highlighting the necessity for meticulous monitoring of hepatic function, particularly in patients with compromised baseline liver reserve. LIMITATIONS: The limitations of this study include its retrospective design and the potential for selection bias arising from the requirement for at least 2 months of treatment.