Cancers (Jul 2021)

Characteristics and Lenvatinib Treatment Response of Unresectable Hepatocellular Carcinoma with Iso-High Intensity in the Hepatobiliary Phase of EOB-MRI

  • Akinori Kubo,
  • Goki Suda,
  • Megumi Kimura,
  • Osamu Maehara,
  • Yoshimasa Tokuchi,
  • Takashi Kitagataya,
  • Masatsugu Ohara,
  • Ren Yamada,
  • Taku Shigesawa,
  • Kazuharu Suzuki,
  • Naoki Kawagishi,
  • Masato Nakai,
  • Takuya Sho,
  • Mitsuteru Natsuizaka,
  • Kenichi Morikawa,
  • Koji Ogawa,
  • Shunsuke Ohnishi,
  • Naoya Sakamoto

DOI
https://doi.org/10.3390/cancers13143633
Journal volume & issue
Vol. 13, no. 14
p. 3633

Abstract

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In hepatocellular carcinoma (HCC), CTNNB-1 mutations, which cause resistance to immune checkpoint inhibitors, are associated with HCC with iso-high intensity in the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) in resectable HCC; however, analyses on unresectable HCC are lacking. This study analyzed the prevalence, characteristics, response to lenvatinib, and CTNNB-1 mutation frequency in unresectable HCC with iso-high intensity in the hepatobiliary phase of EOB-MRI. In 52 patients with unresectable HCC treated with lenvatinib, the prevalence of iso-high intensity in the hepatobiliary phase of EOB-MRI was 13%. All patients had multiple HCCs, and 3 patients had multiple HCCs with iso-high intensity in the hepatobiliary phase of EOB-MRI. Lenvatinib response to progression-free survival and overall survival were similar between patients with or without iso-high intensity in the hepatobiliary phase of EOB-MRI. Seven patients (three and four patients who had unresectable HCC with or without iso-high intensity in the hepatobiliary phase of EOB-MRI, respectively) underwent genetic analyses. Among these, two (67%, 2/3) who had HCC with iso-high intensity in the hepatobiliary phase of EOB-MRI carried a CTNNB-1 mutation, while all four patients who had HCC without iso-high intensity in the hepatobiliary phase of EOB-MRI did not carry the CTNNB-1 mutation. This study’s findings have clinical implications for the detection and treatment of HCC with iso-high intensity in the hepatobiliary phase of EOB-MRI.

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