Lenvatinib versus Sorafenib as first-line treatment in hepatocellular carcinoma: a multi-institutional matched case-control study.

BACKGROUND Advanced Hepatocarcinoma (HCC) is an important health problem world-wide. Recently, the REFLECT trial demonstrated the non-inferiority of Lenvatinib compared to Sorafenib in I line setting, thus leading to the approval of new first-line standard of care, along with Sorafenib. AIMS AND METHODS With aim to evaluate the optimal choice between Sorafenib and Lenvatinib as primary treatment in clinical practice, we performed a multicentric analysis with the propensity score matching on 184 HCC patients. RESULTS The median OS were 15.2 and 10.5 months for Lenvatinib and Sorafenib arm, respectively. The median PFS was 7.0 and 4.5 months for Lenvatinib and Sorafenib arm, respectively. Patients treated with Lenvatinib showed a 36% reduction of death risk (p=0.0156), a 29% reduction of progression risk (p=0.0446), a higher response rate (p NV, ECOG>0, NLR 0 negatively predicted the response to Sorafenib. CONCLUSIONS Lenvatinib showed to better perform in a real-word setting compared to Sorafenib. More researches are needed to validate the predictor factors of response to Lenvatinib rather than Sorafenib. This article is protected by copyright. All rights reserved.