Despite medical advances and new therapeutic developments, hepatocellular carcinoma (HCC) remains difficult to treat; in part, this is due to the fact that HCC, like many liver cancers, is often not diagnosed until later stages. New and effective therapeutic options are needed sooner rather than later. Jordyn Sava, in Cure Today, reports that Lenvima (lenvatinib) has the potential to be one of these options. Clinical study results suggest that second-line Lenvima could improve overall survival in HCC. 

Lenvima is an orally administered tyrosine kinase inhibitor (TKI) that aims to stop cancerous cell proliferation. It is an approved treatment for HCC, advanced renal cell carcinoma (RCC), and differentiated thyroid cancer. 

In data presented at the 2023 Gastrointestinal Cancers Symposium, Lenvima was shown to reduce symptoms and slow disease progression in those with HCC who had progressed on first-line therapy. Researchers sourced data from 53 patients with advanced HCC who received Lenvima after initial immunotherapy treatment. 85% of patients received Lenvima as a second-line therapy, with the remaining 15% receiving it as a third-line therapy. Findings included:

• Common adverse reactions to Lenvima include high blood pressure, elevated AST and/or bilirubin, anorexia, fatigue, and diarrhea. 
• 40% of patients using this treatment also reported severe side effects including the above symptoms, as well as unintended weight loss, confusion, thyroid underactivity, high blood potassium levels, proteinuria, joint pain, swollen and painful hands and feet, mouth ulcers, and kidney or heart injury. 
• Second-line Lenvima helped sustain progression-free and overall survival rates in a similar way to first-line Lenvima. 

What is Hepatocellular Carcinoma (HCC)? 

Hepatocellular carcinoma, although rare, is considered to be the most common form of primary liver cancer. Primary liver cancer means it originates in the liver, rather than spreading from another area of the body. Though doctors are unsure of the exact cause of HCC, they have identified risk factors. These include obesity, diabetes, heavy alcohol consumption, hepatitis B or C, older age, being male, and pre-existing liver conditions. Symptoms and characteristics of HCC can, but do not always, include: 

• Unintended weight loss
• Appetite loss
• Nausea and vomiting
• Jaundice (yellowing of the skin, eyes, and mucous membranes) 
• Feeling of fullness or heaviness, a knot, or a lump in the upper right abdomen
• Abdominal bloating or swelling
• Enlarged spleen
• Skin itchiness
• Pale bowel movements and dark urine
• General weakness and fatigue 
• Easy bruising and/or bleeding

Treatment options can include surgery, liver transplants, radiation, chemotherapy, radiation, percutaneous ethanol injection, and ablation.