{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:22:26Z","timestamp":1792678946448,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T00:00:00Z","timestamp":1634774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Advanced Hepatocarcinoma (HCC) is an important health problem worldwide. Recently, the REFLECT trial demonstrated the non\u2010inferiority of Lenvatinib compared to Sorafenib in I line setting, thus leading to the approval of new first\u2010line standard of care, along with Sorafenib.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims and methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median overall survival (OS) were 15.2 and 10.5\u00a0months for Lenvatinib and Sorafenib arm, respectively. The median progression\u2010free survival (PFS) was 7.0 and 4.5\u00a0months for Lenvatinib and Sorafenib arm, respectively. Patients treated with Lenvatinib showed a 36% reduction of death risk (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0156), a 29% reduction of progression risk (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0446), a higher response rate (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.00001) and a higher disease control rate (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002). Sorafenib showed to be correlated with more hand\u2010foot skin reaction and Lenvatinib with more hypertension and fatigue. We highlighted the prognostic role of Barcelona Clinic Liver Cancer (BCLC) stage, Eastern Cooperative Oncology Group Performance Status (ECOG\u2010PS), bilirubin, alkaline phosphatase and eosinophils for Sorafenib. Conversely, albumin, aspartate aminotransferase (AST), alkaline phosphatase and Neutrophil\u2010Lymphocyte Ratio (NLR) resulted prognostic in Lenvatinib arm. Finally, we highlighted the positive predictive role of albumin\u00a0&gt;\u00a0Normal Value (NV), ECOG\u00a0&gt;\u00a00, NLR\u00a0&lt;\u00a03, absence of Hepatitis C Virus positivity, and presence of portal vein thrombosis in favor of Lenvatinib arm. Eosinophil\u00a0&lt;\u00a050 and ECOG\u00a0&gt;\u00a00 negatively predicted the response to Sorafenib.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SLenvatinib showed to better perform in a real\u2010word setting compared to Sorafenib. More researches are needed to validate the predictor factors of response to Lenvatinib rather than Sorafenib.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.13718","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T16:54:49Z","timestamp":1633020889000},"page":"1229-1241","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Lenvatinib versus Sorafenib as first\u2010line treatment in hepatocellular carcinoma: A multi\u2010institutional matched case\u2010control study"],"prefix":"10.1111","volume":"51","author":[{"given":"Margherita","family":"Rimini","sequence":"first","affiliation":[{"name":"Division of Oncology, Department of Oncology and Hematology University of Modena and Reggio Emilia  Modena 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