tbuckley/cabot-search huggingface dataset:
Pain patterns in chronic pancreatitis: a nationwide longitudinal cohort study
Authors: Marinus A Kempeneers, Yama Issa, Robert C Verdonk, Marco Bruno, P Fockens, Harry van Goor, Eline Alofs, Thomas L Bollen, Stefan Bouwense, Anne S H M van Dalen, Susan van Dieren, Hendrik M van Dullemen, Erwin-Jan van Geenen, Chantal Hoge, Jeanin E van Hooft, Liesbeth M Kager, Yolande Keulemans, Lynn E Nooijen, Jan-Werner Poley, Tom C J Seerden, Adriaan Tan, Willem Thijs, Robin Timmer, Frank Vleggaar, Ben Witteman, Usama Ahmed Ali, Marc G Besselink, Marja A Boermeester, Hjalmar C van Santvoort
Journal: Gut (2020)

Objective Pain in chronic pancreatitis is subdivided in a continuous or intermittent pattern, each thought to represent a different entity, requiring specific treatment. Because evidence is missing, we studied pain patterns in a prospective longitudinal nationwide study. Design 1131 patients with chronic pancreatitis (fulfilling M-ANNHEIM criteria) were included between 2011 and 2018 in 30 Dutch hospitals. Patients with continuous or intermittent pain were compared for demographics, pain characteristics, quality of life (Short-Form 36), imaging findings, disease duration and treatment. Alternation of pain pattern and associated variables were longitudinally assessed using a multivariable multinomial logistic regression model. Results At inclusion, 589 patients (52%) had continuous pain, 231 patients (20%) had intermittent pain and 311 patients (28%) had no pain. Patients with continuous pain had more severe pain, used more opioids and neuropathic pain medication, and had a lower quality of life. There were no differences between pain patterns for morphological findings on imaging, disease duration and treatment. During a median follow-up of 47 months, 552 of 905 patients (61%) alternated at least once between pain patterns. All alternations were associated with the Visual Analogue Scale pain intensity score and surgery was only associated with the change from pain to no pain. Conclusion Continuous and intermittent pain patterns in chronic pancreatitis do not seem to be the result of distinctly different pathophysiological entities. The subjectively reported character of pain is not related to imaging findings or disease duration. Pain patterns often change over time and are merely a feature of how severity of pain is experienced.
Biomimetic glycosaminoglycan-based scaffolds improve skeletal muscle regeneration in a Murine volumetric muscle loss model
Authors: Naagarajan Narayanan, Zhihao Jia, Kun Ho Kim, Liangju Kuang, Paul Lengemann, Gabrielle Shafer, Victor Bernal-Crespo, Shihuan Kuang, Meng Deng
Journal: Bioactive Materials (2020)

Volumetric muscle loss (VML) injuries characterized by critical loss of skeletal muscle tissues result in severe functional impairment. Current treatments involving use of muscle grafts are limited by tissue availability and donor site morbidity. In this study, we designed and synthesized an implantable glycosaminoglycan-based hydrogel system consisting of thiolated hyaluronic acid (HA) and thiolated chondroitin sulfate (CS) cross-linked with poly(ethylene glycol) diacrylate to promote skeletal muscle regeneration of VML injuries in mice. The HA-CS hydrogels were optimized with suitable biophysical properties by fine-tuning degree of thiol group substitution to support C2C12 myoblast proliferation, myogenic differentiation and expression of myogenic markers MyoD, MyoG and MYH8. Furthermore, in vivo studies using a murine quadriceps VML model demonstrated that the HA-CS hydrogels supported integration of implants with the surrounding host tissue and facilitated migration of Pax7+ satellite cells, de novo myofiber formation, angiogenesis, and innervation with minimized scar tissue formation during 4-week implantation. The hydrogel-treated and autograft-treated mice showed similar functional improvements in treadmill performance as early as 1-week post-implantation compared to the untreated groups. Taken together, our results demonstrate the promise of HA-CS hydrogels as regenerative engineering matrices to accelerate healing of skeletal muscle injuries.
Ceria-based nanotheranostic agent for rheumatoid arthritis
Authors: Irina Kalashnikova, Seock-Jin Chung, Md Nafiujjaman, Meghan L. Hill, Mzingaye E. Siziba, Christopher H. Contag, Taeho Kim
Journal: Theranostics (2020)

Rheumatoid arthritis (RA) is an autoimmune disease that affects 1-2% of the human population worldwide, and effective therapies with targeted delivery for local immune suppression have not been described. We address this problem by developing a novel theranostic nanoparticle for RA and assessed its therapeutic and targeting effects under image-guidance.
Large-Scale Characterization of Drug Responses of Clinically Relevant Proteins in Cancer Cell Lines
Authors: Wei Zhao, Jun Li, Mei-Ju M. Chen, Yikai Luo, Zhenlin Ju, Nicole K. Nesser, Katie Johnson-Camacho, Christopher T. Boniface, Yancey Lawrence, Nupur T. Pande, Michael A. Davies, Meenhard Herlyn, Taru Muranen, Ioannis K. Zervantonakis, Erika von Euw, Andre Schultz, Shwetha V. Kumar, Anil Korkut, Paul T. Spellman, Rehan Akbani, Dennis J. Slamon, Joe W. Gray, Joan S. Brugge, Yiling Lu, Gordon B. Mills, Han Liang
Journal: Cancer Cell (2020)
Factors Predictive of Oral Abstract Being Published: Is Gender Disparity Playing a Role?
Authors: Ankita Kapoor, Mehul P. Patel, Arjun Khunger, Mazen Jizzini, Mohammad Ammad Ud Din, Simrat Gill, Samar Nasir, Dharmini Manogna, Roopali Goyal Gandhi, Nikhil Agrawal, Syed Ather Hussain, Pulkit Gandhi, Saad Jamshed
Journal: Blood (2020)
Oral Administration of FT-4202, an Allosteric Activator of Pyruvate Kinase-R, Has Potent Anti-Sickling Effects in a Sickle Cell Anemia (SCA) Mouse Model, Resulting in Improved RBC Survival and Hemoglobin Levels
Authors: Archana Shrestha, Mengna Chi, Kimberly Wagner, Adam Drake, Keertik Fulzele, Sylvie Guichard, Punam Malik
Journal: Blood (2020)
Randomized Phase 2 Trial of Pevonedistat Plus Azacitidine Versus Azacitidine in Higher-Risk Myelodysplastic Syndromes/Chronic Myelomonocytic Leukemia or Low-Blast Acute Myeloid Leukemia: Exploratory Analysis of Patient-Reported Outcomes
Authors: Joshua F. Zeidner, Flora Mazerolle, Jill A. Bell, Lauren E. Cain, Douglas V. Faller, Mehul Dalal, Antoine Regnault, Robert J. Fram
Journal: Blood (2020)
Multicenter Long Term Follow-up in Hairy Cell Leukemia Patients Treated with Cladribine: A Thirty-Year Experience
Authors: Marianna Criscuolo, Alessandro Broccoli, Eugenio Galli, Alfonso Piciocchi, Alessio Maraglino, Antonella Anastasia, Ombretta Annibali, Maria Cantonetti, Maria Lucia De Luca, Luana Fianchi, Annamaria Frustaci, Elettra Galli, Luca Guarnera, Sofia Kovalchuk, Francesco Marchesi, Marina Motta, Maria Elena Nizzoli, Massimo Offidani, Lorella Orsucci, Angelica Spolzino, Caterina Stelitano, Sergio Storti, Alessandra Tedeschi, Livio Trentin, Marzia Varettoni, Andrea Visentin, Stefano Volpetti, Brunangelo Falini, Alessandro Pulsoni, Enrico Tiacci, Pier Luigi Zinzani, Livio Pagano
Journal: Blood (2020)
Analysis of Clonal Evolution of AML Using Simultaneous Single-Cell DNA/RNA Analysis
Authors: Ryosaku Inagaki, Masahiro Marshall Nakagawa, Yasuhito Nannya, Qi Xingxing, Lanying Zhao, June Takeda, Akinori Yoda, Ayana Kon, Hisashi Tsurumi, Hideki Makishima, Seishi Ogawa
Journal: Blood (2020)
A First-in-Human (FIH) Phase 1 Study of the Anti-LILRB4 Antibody IO-202 in Relapsed/Refractory (R/R) Myelomonocytic and Monocytic Acute Myeloid Leukemia (AML) and R/R Chronic Myelomonocytic Leukemia (CMML)
Authors: Courtney D. DiNardo, Daniel A. Pollyea, Marina Konopleva, Kyu Hong, Tao Huang, An Song, Elizabeth Wieland, Paul Woodard, Charlene Liao, Chengcheng Zhang, Prapti A. Patel, Ahmed Aribi
Journal: Blood (2020)
Abstract 218: Magnesium Deficiency Causes Reversible Diastolic and Systolic Cardiomyopathies by Impairing Mitochondrial Function
Authors: Man Liu, Hong Liu, An Xie, Xiaoxu Zhou, Feng Feng, Samuel C Dudley
Journal: Circulation Research (2020)

Introduction: Hypomagnesemia is common in patients with diabetes, hypertension, and heart failure. A low circulating Mg level is associated with increased cardiovascular mortality, and conversely, dietary magnesium (Mg) intake is associated with a decreased risk of developing heart failure. In this study, we investigated whether Mg deficiency alone contributed to cardiomyopathy. Methods: C57BL/6J mice were fed with a low-Mg diet (low-Mg, 15-30 mg/kg Mg) or a normal Mg diet (nl-Mg, 600 mg/kg Mg) for 6 weeks. To test reversibility, half of the low-Mg mice were fed then with normal diet for another 6 weeks. Results: Mg deficiency increased mortality. The survival rate after 6-week low-Mg diet was 0 for female and 64.6% for male. Surviving male mice showed significantly decreased serum Mg (0.9±0.1 vs. 2.8±0.1 mg/dL for nl-Mg) and a reciprocal increase in serum Ca, K and Na. Mg deficiency was associated with a decreased ejection fraction (EF%, 39.8±1.9% vs. 52.0±1.7% of nl-Mg), diastolic dysfunction (E/e’: 21.1±1.1 vs. 15.4±0.4 of nl-Mg), and prolonged QTc intervals (55.1±0.8 vs. 46.0±1.2 ms of nl-Mg). At the cellular level, ATP, Ca transient amplitude, resting sarcomere length, and sarcomere shortening were all decreased significantly in low-Mg hearts. These changes were accompanied by significantly increased mitochondrial ROS production. Reintroduction of Mg normalized electrolytes, EF% (52.1±1.4%), E/e’ (15.3±0.7), QTc (49.4±1.7 ms) and cellular changes. SERCA2 was decreased, and oxidation of RyR2 and cardiac myosin binding protein C were increased in low-Mg hearts, all of which were reversed by Mg repletion. In vivo mitoTEMPO treatment on low-Mg mice (1 mg/kg/day IP injection for 2 weeks) improved the diastolic function (E/e’=16.7±2.0) and increased cellular ATP levels. Conclusion: Mg deficiency causes reversible diastolic and systolic cardiomyopathy associated with mitochondrial dysfunction. This cardiomyopathy may explain the relationship of hypomagnesemia and worsening heart failure. Mg intake reverses these changes, reinforcing the known correlation of increased Mg intake and reduced heart failure symptoms. In deficiency states, Mg supplementation may represent a novel treatment for both diastolic and systolic heart failure.
Phase 2 Trial of Ixazomib, Cyclophosphamide and Dexamethasone for Treatment of Previously Untreated Light Chain Amyloidosis
Authors: Eli Muchtar, Morie A Gertz, Betsy Laplant, Francis K. Buadi, Nelson Leung, Stephanie M. Peterson, P. Leif Bergsagel, Amie Fonder, Yi L. Hwa, Miriam A. Hobbs, Dania Kaehlyn Helgeson, Alanna M. Vossen, Wilson I Gonsalves, Martha Q. Lacy, Prashant Kapoor, Mustaqeem A. Siddiqui, Jeremy Larsen, Rahma M Warsame, Suzanne R. Hayman, Ronald S. Go, David Dingli, Taxiarchis Kourelis, Angela Dispenzieri, S. Vincent Rajkumar, Shaji K. Kumar
Journal: Blood (2020)
Abstract 417: Cardiac Akap12 Signalosome Overexpression Exacerbation of Heart Failure and β-arrestin Signaling Pathway
Authors: Hanan Qasim, Arfaxad Reyes Alcaraz, Bradley K McConnell
Journal: Circulation Research (2020)

Background: Heart failure (HF) is responsible for 1 out of 8 deaths per year in the U.S.A. andis the major cause of death globally. In HF, chronic β-adrenergic receptor (β-AR)stimulation leads to reduced cardiac function due in part to β-AR desensitization.β-arrestins are proteins that play a major role in desensitizing G protein-coupledreceptors (GPCRs) such as β-AR. Previously we reported enhanced cardiacfunction in mice lacking functional A Kinase Anchoring Protein 12 (AKAP12). Inthis study, we aim to investigate the impact of AKAP12 overexpression(oxAKAP12) on HF progression through assessing β-arrestins. Our central hypothesis is that cardiac AKAP12 overexpression potentiates HF developmentby influencing β-arrestin signaling downstream of the β-AR. Methods: HF was developed in WT and oxAKAP12-Tg mice (8-10) weeks old males andfemales, through chronic Isoproterenol (ISO) administration (60mg/kg/day for 14days). Left ventricular homogenates were used for gene expression analysis.Furthermore, AKAP12 was transiently overexpressed in AC16 cells (humancardiomyocytes cell line), to asses protein expression levels and Gαs pathwayactivity, upon treatment with 100 nM of ISO. Results: Cardiac oxAKAP12 in both males and females reduced left ventricular ejectionfraction (EF) by 14.5±2.5% and fractional shortening (FS) by 22.7±2% after 14-days of chronic ISO treatment when compared to control groups. β-arrestin-1gene expression levels were significantly lower (p=0.022) in oxAKAP12 malehomogenates treated with ISO (14 days) compared to control groups.Interestingly, female homogenates overexpressing AKAP12 showed significantlyhigher β-arrestin-1 gene expression levels (p&lt;0.0001) with ISO treatment,compared to control groups. In AC16 cells overexpressing AKAP12 and treatedwith ISO, Gαs activity and β-arrestin-1 protein expression levels were bothreduced by 50% compared to AC16 ISO treated groups. Conclusion: Cardiac oxAKAP12 negatively influences systolic function in both male andfemale mice, potentially through affecting β-arrestin signaling pathway. Thus,designing novel drugs to inhibit AKAP12 is promising to ameliorate HF.
Genetic Determinants of Blood Cell Traits Play a Role in Susceptibility to Acute Lymphoblastic Leukemia
Authors: Linda Kachuri, Soyoung Jeon, Andrew T. DeWan, Catherine Metayer, John S. Witte, Xiaomei Ma, Charleston W. K. Chiang, Joseph L. Wiemels, Adam J. de Smith
Journal: Blood (2020)
Ibrutinib (Ibr) Plus Venetoclax (Ven) for First-Line Treatment of Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL): 1-Year Disease-Free Survival (DFS) Results From the MRD Cohort of the Phase 2 CAPTIVATE Study
Authors: William G. Wierda, Constantine S. Tam, John N. Allan, Tanya Siddiqi, Thomas J. Kipps, Stephen Opat, Alessandra Tedeschi, Xavier C. Badoux, Bryone J. Kuss, Sharon Jackson, Carol Moreno, Ryan Jacobs, John M. Pagel, Ian W. Flinn, Cathy Zhou, Edith Szafer-Glusman, Joi Ninomoto, James P. Dean, Danelle F. James, Paolo Ghia
Journal: Blood (2020)
RG6076 (CD19-4-1BBL): CD19-Targeted 4-1BB Ligand Combination with Glofitamab As an Off-the-Shelf, Enhanced T-Cell Redirection Therapy for B-Cell Malignancies
Authors: Sylvia Herter, Johannes Sam, Claudia Ferrara Koller, Sarah Diggelmann, Esther Bommer, Anne Schönle, Christina Claus, Marina Bacac, Christian Klein, Pablo Umana
Journal: Blood (2020)
Youth running consensus statement: minimising risk of injury and illness in youth runners
Authors: Brian J Krabak, William O Roberts, Adam S Tenforde, Kathryn E Ackerman, Paolo Emilio Adami, Aaron L Baggish, Michelle Barrack, John Cianca, Irene Davis, Pierre D"Hemecourt, Michael Fredericson, Joshua T Goldman, Mark A Harrast, Bryan C Heiderscheit, Karsten Hollander, Emily Kraus, Anthony Luke, Emily Miller, Melissa Moyer, Mitchell J Rauh, Brett G Toresdahl, Meagan M Wasfy
Journal: British Journal of Sports Medicine (2020)

Despite the worldwide popularity of running as a sport for children, relatively little is known about its impact on injury and illness. Available studies have focused on adolescent athletes, but these findings may not be applicable to preadolescent and pubescent athletes. To date, there are no evidence or consensus-based guidelines identifying risk factors for injury and illness in youth runners, and current recommendations regarding suitable running distances for youth runners at different ages are opinion based. The International Committee Consensus Work Group convened to evaluate the current science, identify knowledge gaps, categorise risk factors for injury/illness and provide recommendations regarding training, nutrition and participation for youth runners.
Prevalence of High Tumor Mutational Burden and Association With Survival in Patients With Less Common Solid Tumors
Authors: Changxia Shao, Gerald Li, Lingkang Huang, Scott Pruitt, Emily Castellanos, Garrett Frampton, Kenneth R. Carson, Tamara Snow, Gaurav Singal, David Fabrizio, Brian M. Alexander, Fan Jin, Wei Zhou
Journal: JAMA Network Open (2020)

Tumor mutational burden (TMB) is a potential biomarker associated with response to immune checkpoint inhibitor therapies. The prognostic value associated with TMB in the absence of immunotherapy is uncertain.To assess the prevalence of high TMB (TMB-H) and its association with overall survival (OS) among patients not treated with immunotherapy with the same 10 tumor types from the KEYNOTE-158 study.This retrospective cohort study evaluated the prognostic value of TMB-H, assessed by Foundation Medicine (FMI) and defined as at least 10 mutations/megabase (mut/Mb) in the absence of immunotherapy. Data were sourced from the deidentified Flatiron Health-FMI clinicogenomic database collected up to July 31, 2018. Eligible patients were aged 18 years or older with any of the following solid cancer types: anal, biliary, endometrial, cervical, vulvar, small cell lung, thyroid, salivary gland, mesothelioma, or neuroendocrine tumor. Patients with microsatellite instability-high tumors were excluded from primary analysis. For OS analysis, patients were excluded if immunotherapy started on the FMI report date or earlier or if patients died before January 1, 2012, and patients were censored if immunotherapy was started later than the FMI report date. Data were analyzed from November 2018 to February 2019.Overall survival was analyzed using the Kaplan-Meier method and Cox proportional hazards model, adjusting for age, sex, cancer types, practice type, and albumin level.Of 2589 eligible patients, 1671 (64.5%) were women, and the mean (SD) age was 63.7 (11.7) years. Median (interquartile range) TMB was 2.6 (1.7-6.1) mut/Mb, and 332 patients (12.8%) had TMB-H (≥10 mut/Mb). Prevalence of TMB-H was highest among patients with small cell lung cancer (40.0%; 95% CI, 34.7%-45.6%) and neuroendocrine tumor (29.3%; 95% CI, 22.8%-36.6%) and lowest was among patients with mesothelioma (1.2%; 95% CI, 0.3%-4.4%) and thyroid cancer (2.7%; 95% CI, 1.2%-5.7%). Adjusted hazard ratio for OS of patients not treated with immunotherapy with TMB-H vs those without TMB-H was 0.94 (95% CI, 0.77-1.13). Comparable results were observed when including patients with high microsatellite instability tumors and calculating OS from first observed antineoplastic treatment date.These findings suggest that prevalence of TMB-H varies widely depending on tumor type and TMB-H does not appear to be a factor associated with OS among patients across these cancer types treated in the absence of immunotherapy.
Abstract 484: Alcohol Abuse Increases the Risk of In-hospital Mortality in Arrhythmia: A Nationwide Analysis of 114,958 Inpatients
Authors: RIKINKUMAR S PATEL, Virendrasinh Ravat, Temitope Ajibawo
Journal: Circulation Research (2020)

Objectives: In our study, we aim 1. to evaluate the differences in demographics in arrhythmia inpatients by comorbid alcohol abuse, and 2. to assess the risk of in-hospital mortality due to alcohol abuse. Methods: We conducted a cross-sectional analysis using the nationwide inpatient sample (NIS, 2010-2014). We included 114,958 patients (age, 15-54y) hospitalized for arrhythmia and further grouped by comorbid alcohol abuse. Logistic regression was done to measure the odds ratio (OR) of association of alcohol abuse with mortality. Results: The prevalence of alcohol abuse in arrhythmia inpatients was 9.75%., and these patients were old-age (45-54y, 68%), male (85.9%) and White (69%). The mortality risk statistically increases with age with adults (45-5y) having two times higher risk (95% CI 1.5-3.1). Males had a lower risk compared to females (OR 0.8, 95% CI 0.7-0.9). Atherosclerosis (OR 4.5, 95% CI 3.4-5.9) and diabetes (OR 1.4, 95% CI 1.2-1.7) significantly increased mortality risk in arrhythmia inpatients. Mortality was seen in a higher proportion of alcohol abusers (1.9%) cohort compared to non-users (1.4%). And, alcohol abuse increased the risk of mortality during hospitalization (OR 1.7, 95% CI 1.4-2.1) after controlling for demographic confounders and cardiovascular comorbidities. Conclusions: The risk of mortality is higher in older-age adults and females with arrhythmia. Alcohol abuse independently increases the risk of mortality by 72% in arrhythmia inpatients. Social alcohol drinking and its impact on arrhythmias in non-alcoholics needs to be studied. Strategies to reduce alcohol consumption and abstinence should be focussed to improve the quality of life of patients with cardiovascular risk factors.
Impact of Minimal Residual Disease (MRD) Assessed before Transplantation on the Outcome of Children with Acute Myeloid Leukemia Given an Allograft: A Retrospective Study By the I-BFM Study Group
Authors: Martina Pigazzi, Maddalena Benetton, Christiane Walter, Maria Hansen, Anne-Sofie Skou, Ambra Da Ros, Anna Marchetti, Katia Polato, Mattia Belloni, Claudia Tregnago, Jonas Abrahamsson, Linda Fogelstrand, Nils Von Neuhoff, Dirk Reinhardt, Henrik Hasle, Franco Locatelli, Pietro Merli
Journal: Blood (2020)
Asciminib, a First-in-Class STAMP Inhibitor, Provides Durable Molecular Response in Patients (pts) with Chronic Myeloid Leukemia (CML) Harboring the T315I Mutation: Primary Efficacy and Safety Results from a Phase 1 Trial
Authors: Jorge E. Cortes, Timothy P. Hughes, Michael J. Mauro, Andreas Hochhaus, Delphine Rea, Yeow Tee Goh, Jeroen Janssen, Juan Luis Steegmann, Michael C. Heinrich, Moshe Talpaz, Gabriel Etienne, Massimo Breccia, Michael W. Deininger, Philipp D le Coutre, Fabian Lang, Paola Aimone, Fotis Polydoros, Silvia Cacciatore, Laura Stenson, Dong-Wook Kim
Journal: Blood (2020)
Lenvatinib-Transarterial Chemoembolization Sequential Therapy as an Effective Treatment at Progression during Lenvatinib Therapy for Advanced Hepatocellular Carcinoma
Authors: Yusuke Kawamura, Masahiro Kobayashi, Junichi Shindoh, Yuta Kobayashi, Satoshi Okubo, Licht Tominaga, Akira Kajiwara, Kayoko Kasuya, Soichi Iritani, Shunichiro Fujiyama, Tetsuya Hosaka, Satoshi Saitoh, Hitomi Sezaki, Norio Akuta, Fumitaka Suzuki, Yoshiyuki Suzuki, Kenji Ikeda, Yasuji Arase, Masaji Hashimoto, Tokuyo Kozuka, Hiromitsu Kumada
Journal: Liver Cancer (2020)

The aims of this study were to evaluate the efficacy of additional treatment, especially lenvatinib-transarterial chemoembolization (TACE) sequential therapy, for unresectable hepatocellular carcinoma (HCC).Consecutive 56 patients who underwent lenvatinib treatment were reviewed. Oncological aggressiveness of tumor was estimated using a dynamic CT enhancement pattern classification, and clinical impact of subsequent treatment was investigated through analysis of progression-free survival (PFS), post-progression survival (PPS), and multivariate analysis of potential confounders for survival after progression during lenvatinib therapy.Heterogeneous enhancement patterns (Type-3 and -4), which are reportedly associated with higher oncological aggressiveness of HCC, were associated with better objective response to lenvatinib compared to homogeneous enhancement pattern (Type-2) (86 and 85% vs. 53% in modified Response Evaluation Criteria in Solid Tumors), resulting in similar PFS (p = 0.313). Because of significantly worse PPS, overall survival of Type-4 tumor was poor compared to Type-2 or -3 tumors (p = 0.009). However, subgroup of patients who achieved subsequent treatment showed significantly better PPS, regardless of CT enhancement pattern. Multivariate analysis confirmed that use of lenvatinib-TACE sequential treatment after progression during lenvatinib therapy was associated with better PPS (hazard ratio [HR], 0.08; 95% CI, 0.01-0.71; p = 0.023), while Type-4 enhancement pattern was correlated with worse PPS (HR, 2.92; 95% CI, 1.06-8.05; p = 0.039).Oncological aggressiveness of HCC estimated by CT enhancement pattern was predictive of PPS after progression during lenvatinib. Successful subsequent treatment with lenvatinib-TACE sequential therapy may offer survival benefit regardless of CT enhancement pattern of HCC.