COMPARISON OF RESPONSE RATE OF SORAFENIB VS LENVATINIB IN HEPATOCELLULAR CARCINOMA PATIENTS

Abstract

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide. A large proportion of patients present with unresectable disease, where systemic therapy remains the cornerstone of management. Sorafenib and lenvatinib are tyrosine kinase inhibitors approved as first-line treatment for unresectable HCC; however, comparative data regarding their objective response rates in local populations are limited.

Objective: To compare the objective response rate of sorafenib versus lenvatinib in patients with hepatocellular carcinoma

Methodology: This randomized controlled trial was conducted in the Department of Oncology and Radiotherapy, Mayo Hospital, Lahore, from March 2025 to June 2025. A total of 70 patients with biopsy-proven hepatocellular carcinoma and underlying cirrhosis were enrolled using non-probability consecutive sampling. Patients were randomized into two equal groups: Group A received sorafenib (400 mg orally twice daily), and Group B received lenvatinib (8 mg orally once daily). Tumor response was assessed at three months using RECIST version 1.1 criteria. Objective response rate (ORR) was calculated as the sum of complete and partial responses. Data were analyzed using SPSS version 25.

Results: The objective response rate was higher in the lenvatinib group compared to the sorafenib group. Lenvatinib demonstrated a greater proportion of partial responses, whereas stable disease was more commonly observed with sorafenib. The difference in ORR between the two groups was statistically significant (p ≤ 0.05)

Conclusion: Lenvatinib showed a significantly higher objective response rate compared to sorafenib in patients with hepatocellular carcinoma, suggesting superior tumor control. Lenvatinib may be considered a preferred first-line systemic therapy in eligible HCC patients.