Evidence map›Paper›PMID 36961524›Full record

ArticleCancer chemotherapy and pharmacology2023

Progressive erythrocytosis under lenvatinib treatment in patients with advanced hepatocellular carcinoma.

Laurence Legros, Alina Pascale, Catherine Guettier, Pirayeh Eftekhari, Yasmina Ben Merabet, Maryse Stang, Rachel Bossevot, Emma Goldschmidt, Ayhan Ulusakarya, Stephane Morisset and 3 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer chemotherapy and pharmacology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 1 country.

Laurence Legros *Department of Clinical Hematology, Hôpital Bicêtre, AP-HP, 78 Rue du Général Leclerc 94270, Le Kremlin-Bicêtre, France. laurence.legros@aphp.fr.ORCID http://orcid.org/0000-0002-9567-7879
Alina Pascale *Hepato-Biliary Department, Hôpital Paul Brousse, AP-HP, 12-14 Avenue Paul Vaillant Couturier, 94800, Villejuif, France.ORCID http://orcid.org/0000-0001-9511-3726
Catherine GuettierHepato-Biliary Department, Hôpital Paul Brousse, AP-HP, 12-14 Avenue Paul Vaillant Couturier, 94800, Villejuif, France.ORCID http://orcid.org/0000-0003-0791-5505
Pirayeh EftekhariDepartment of Clinical Hematology, Hôpital Bicêtre, AP-HP, 78 Rue du Général Leclerc 94270, Le Kremlin-Bicêtre, France.
Yasmina Ben MerabetHepato-Biliary Department, Hôpital Paul Brousse, AP-HP, 12-14 Avenue Paul Vaillant Couturier, 94800, Villejuif, France.
Maryse StangMedical Oncology Department, Hôpital Paul Brousse, AP-HP, Villejuif, France.
Rachel BossevotMedical Oncology Department, Hôpital Paul Brousse, AP-HP, Villejuif, France.ORCID http://orcid.org/0000-0002-6646-2481
Emma GoldschmidtMedical Oncology Department, Hôpital Paul Brousse, AP-HP, Villejuif, France.ORCID http://orcid.org/0000-0002-2153-5384
Ayhan UlusakaryaMedical Oncology Department, Hôpital Paul Brousse, AP-HP, Villejuif, France.ORCID http://orcid.org/0000-0001-8683-6818
Stephane MorissetIndependent Biostatistician, Pérouges, France.ORCID http://orcid.org/0000-0002-7747-113X
Maïté LewinRadiology Department, Hôpital Paul Brousse, AP-HP, Villejuif, France.ORCID http://orcid.org/0000-0002-9450-8096
Didier SamuelHepato-Biliary Department, Hôpital Paul Brousse, AP-HP, 12-14 Avenue Paul Vaillant Couturier, 94800, Villejuif, France.ORCID http://orcid.org/0000-0001-9481-3616
Olivier RosmorducHepato-Biliary Department, Hôpital Paul Brousse, AP-HP, 12-14 Avenue Paul Vaillant Couturier, 94800, Villejuif, France. olivier.rosmorduc@aphp.fr.ORCID http://orcid.org/0000-0002-6695-3088
Assistance Publique – Hôpitaux de Paris · FRInserm · FRBiostatistique et processus spatiaux · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis manuscript reports on the occurrence of early and frequent erythrocytosis in advanced hepatocellular carcinoma (HCC) patients treated with lenvatinib.

methodsA cohort of 23 patients with advanced HCC, treated with this antiangiogenic drug for at least one month, was retrospectively analyzed.

resultsThese patients (82.7% men, median age 58.3, cirrhosis in 60.8%) were treated between October 2019 and September 2020 with lenvatinib, as first-line systemic therapy for 82.6% of them. For 20 patients (87%), an early and significant increase in hemoglobin (Hb) level, up to 1.41 g/dL (p < 0.001) was reported and remained elevated. Ten patients (43.5%), all men, reached erythrocytosis (Hb > 16.5 g/dL), 7 were treated with low-dose aspirin for primary thromboprophylaxis and 2 needed phlebotomy. None underwent thromboembolic complications. A significant Hb decrease was observed after treatment discontinuation (p < 0.05). Erythropoietin (EPO) serum levels also increased, which was attributed to HCC after immunostaining for EPO in liver biopsies. The Naranjo adverse drug reaction probability scale documented the relationship between erythrocytosis and lenvatinib and regression at treatment discontinuation. Erythrocytosis was hypothesized to be a class effect of anti-VEGF therapies, the magnitude of which might depend on the IC50 value of each molecule.

conclusionThis report documents the frequent occurrence of erythrocytosis during lenvatinib treatment for advanced HCC, likely secondary to EPO secretion by tumor cells through the antiangiogenic activity levatinib. An early and close monitoring of hematologic parameters is, thus, recommended, together with thromboprophylaxis by low-dose aspirin and phlebotomy in case of symptomatic erythrocytosis.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsPolycythemiaVenous ThromboembolismAnticoagulantsFemaleHumansMaleMiddle AgedPhenylurea CompoundsQuinolinesRetrospective StudiesAnticoagulantslenvatinibPhenylurea CompoundsQuinolinesAntiangiogenic drugsErythrocytosisErythropoietinHepatocellular carcinomaLenvatinibThromboprophylaxis

Identifiers

PMID36961524
PMCPMC10068666
OpenAlexW4360817398

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.