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American Journal of Clinical Oncology:
doi: 10.1097/COC.0b013e3182868c66
Original Article: PDF Only

Lenalidomide for Second-line Treatment of Advanced Hepatocellular Cancer: A Brown University Oncology Group Phase II Study.

Safran, Howard MD; Charpentier, Kevin P. MD; Kaubisch, Andreas MD; Mantripragada, Kalyan MD, MPH; Dubel, Gregory MD; Perez, Kimberly MD; Faricy-Anderson, Katherine MD; Miner, Thomas MD; Eng, Yoko ANP; Victor, Joel MD; Plette, Angela MD; Espat, Joseph MD; Bakalarski, Pamela CCRP, MPA; Wingate, Patti BS; Berz, David MD; Luppe, Denise BSN; Martel, Diane RN; Rosati, Kayla EdM; Aparo, Santiago MD

Published Ahead-of-Print
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Abstract

Purpose: To assess the activity and toxicity of lenalidomide for patients with advanced hepatocellular cancer (HCC) previously treated with sorafenib.

Materials and Methods: Patients with advanced HCC who progressed on or were intolerant to sorafenib were eligible. Patients received lenalidomide 25 mg orally for 1 to 21 days in a 28-day cycle until disease progression or unacceptable toxicities.

Results: Forty patients were enrolled and were classified according to the Child-Pugh score: 19 were Child-Pugh A, 16 patients were Child-Pugh B, and 5 were Child-Pugh C. Seventeen patients had extrahepatic disease. Grade 4 neutropenia occurred in 1 of 40 patients (2.5%). Grade 3 fatigue (n=3) and rash (n=4) were the most common nonhematologic toxicities attributable to lenalidomide. Six of 40 patients (15%) had a partial response. Two patients (5%) have not progressed at 36 and 32 months. The median progression-free survival was 3.6 months and the median overall survival was 7.6 months.

Conclusions: Lenalidomide can be administered to patients with advanced HCC and hepatic dysfunction. Promising, and in a small percentage of patients, durable activity has been demonstrated. Investigations are needed to explore the mechanism of action of lenalidomide in HCC.

(C) 2014 by Lippincott Williams & Wilkins, Inc

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