title: Lenalidomide for second-line treatment of advanced hepatocellular cancer: a Brown University oncology group phase II study.
abstract: OBJECTIVE
  To assess the activity and toxicity of lenalidomide for patients with advanced hepatocellular cancer (HCC) previously treated with sorafenib.
  
  
  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.
authors: *Brown University Oncology Group, Providence RI †Montefiore Medical Center, Bronx, NY.
authors: Howard
authors: H
authors: Safran
authors: Kevin P
authors: KP
authors: Charpentier
authors: Andreas
authors: A
authors: Kaubisch
authors: Kalyan
authors: K
authors: Mantripragada
authors: Gregory
authors: G
authors: Dubel
authors: Kimberly
authors: K
authors: Perez
authors: Katherine
authors: K
authors: Faricy-Anderson
authors: Thomas
authors: T
authors: Miner
authors: Yoko
authors: Y
authors: Eng
authors: Joel
authors: J
authors: Victor
authors: Angela
authors: A
authors: Plette
authors: Joseph
authors: J
authors: Espat
authors: Pamela
authors: P
authors: Bakalarski
authors: Patti
authors: P
authors: Wingate
authors: David
authors: D
authors: Berz
authors: Denise
authors: D
authors: Luppe
authors: Diane
authors: D
authors: Martel
authors: Kayla
authors: K
authors: Rosati
authors: Santiago
authors: S
authors: Aparo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D009536:Niacinamide / Q000031:analogs & derivatives / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use; D000077157:Sorafenib; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D013792:Thalidomide; D000077157:Sorafenib; D000077269:Lenalidomide