TY - JOUR
T1 - Therapeutic efficacy of atezolizumab plus bevacizumab treatment for unresectable hepatocellular carcinoma in patients with Child-Pugh class A or B liver function in real-world clinical practice
AU - Real-life Practice Experts for HCC (RELPEC) Study Group
AU - HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
AU - Tanaka, Takaaki
AU - Hiraoka, Atsushi
AU - Tada, Toshifumi
AU - Hirooka, Masashi
AU - Kariyama, Kazuya
AU - Tani, Joji
AU - Atsukawa, Masanori
AU - Takaguchi, Koichi
AU - Itobayashi, Ei
AU - Fukunishi, Shinya
AU - Tsuji, Kunihiko
AU - Ishikawa, Toru
AU - Tajiri, Kazuto
AU - Ochi, Hironori
AU - Yasuda, Satoshi
AU - Toyoda, Hidenori
AU - Ogawa, Chikara
AU - Nishimura, Takashi
AU - Hatanaka, Takeshi
AU - Kakizaki, Satoru
AU - Shimada, Noritomo
AU - Kawata, Kazuhito
AU - Naganuma, Atsushi
AU - Kosaka, Hisashi
AU - Ohama, Hideko
AU - Nouso, Kazuhiro
AU - Morishita, Asahiro
AU - Tsutsui, Akemi
AU - Nagano, Takuya
AU - Itokawa, Norio
AU - Okubo, Tomomi
AU - Arai, Taeang
AU - Imai, Michitaka
AU - Koizumi, Yohei
AU - Nakamura, Shinichiro
AU - Joko, Kouji
AU - Iijima, Hiroko
AU - Kaibori, Masaki
AU - Hiasa, Yoichi
AU - Kudo, Masatoshi
AU - Kumada, Takashi
N1 - Publisher Copyright:
© 2022 The Authors. Hepatology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Hepatology.
PY - 2022/9
Y1 - 2022/9
N2 - Background/Aim: Atezolizumab plus bevacizumab (Atez/Bev) treatment is recommended for unresechepatocellular carcinoma (u-HCC) patients classified as Child-Pugh A (CP-A). This study aimed to elucidate the prognosis of patients treated with Atez/Bev, especially CP-A and -B cases. Materials/methods: From September 2020 to March 2022, 457 u-HCC patients treated with Atez/Bev were enrolled (median age 74 years, male:female = 368:89, CP-A:CP-B = 427:30, Child-Pugh score [CPS] 5:6:7:8:9 = 271:156:21:8:1). Therapeutic response was evaluated using RECIST ver.1.1. Clinical features and prognosis were retrospectively evaluated. Results: There were no significant differences between CP-A and -B patients in regard to best response (CR:PR:SD:PD = 16:91:194:81 vs. 0:7:13:8, p = 0.739; objective response rate/disease control rate = 28.0%/78.8% vs. 25.0%/71.4%). Analysis performed using inverse probability weighting adjustments of clinical factors other than those related to hepatic reserve function with a p value < 0.10 for comparisons between patients with CP-A and -B showed that the progression-free survival (PFS) rate for CP-A cases was better (6-/12-/18-month: 58.2%/36.1%/27.8% vs. 49.6%/8.7%/non-estimable [NE], p < 0.001), as was overall survival (OS) rate (6-/12-/18-month: 89.9%/71.7%/51.4% versus 63.6%/18.4%/NE; p < 0.001). Median PFS (mPFS) and median OS (mOS) for the CPS-5 were 9.5 months/NE, and 5.1/14.0 months for the CPS-6 (both p < 0.001). Furthermore, for modified albumin-bilirubin grade (mALBI)-1/2a/2b, mPFS was 9.4/8.5/5.3 months (p < 0.001) and mOS was NE/17.8/13.4 months (p < 0.001). Conclusion: Better hepatic function, such as mALBI grade 1 or 2a are thought to indicate a better condition for obtaining sufficient prognosis with Atez/Bev treatment for u-HCC patients, whereas for CP-B patients, who mainly shown an mALBI grade of 2b or 3, Atez/Bev might have less therapeutic efficacy.
AB - Background/Aim: Atezolizumab plus bevacizumab (Atez/Bev) treatment is recommended for unresechepatocellular carcinoma (u-HCC) patients classified as Child-Pugh A (CP-A). This study aimed to elucidate the prognosis of patients treated with Atez/Bev, especially CP-A and -B cases. Materials/methods: From September 2020 to March 2022, 457 u-HCC patients treated with Atez/Bev were enrolled (median age 74 years, male:female = 368:89, CP-A:CP-B = 427:30, Child-Pugh score [CPS] 5:6:7:8:9 = 271:156:21:8:1). Therapeutic response was evaluated using RECIST ver.1.1. Clinical features and prognosis were retrospectively evaluated. Results: There were no significant differences between CP-A and -B patients in regard to best response (CR:PR:SD:PD = 16:91:194:81 vs. 0:7:13:8, p = 0.739; objective response rate/disease control rate = 28.0%/78.8% vs. 25.0%/71.4%). Analysis performed using inverse probability weighting adjustments of clinical factors other than those related to hepatic reserve function with a p value < 0.10 for comparisons between patients with CP-A and -B showed that the progression-free survival (PFS) rate for CP-A cases was better (6-/12-/18-month: 58.2%/36.1%/27.8% vs. 49.6%/8.7%/non-estimable [NE], p < 0.001), as was overall survival (OS) rate (6-/12-/18-month: 89.9%/71.7%/51.4% versus 63.6%/18.4%/NE; p < 0.001). Median PFS (mPFS) and median OS (mOS) for the CPS-5 were 9.5 months/NE, and 5.1/14.0 months for the CPS-6 (both p < 0.001). Furthermore, for modified albumin-bilirubin grade (mALBI)-1/2a/2b, mPFS was 9.4/8.5/5.3 months (p < 0.001) and mOS was NE/17.8/13.4 months (p < 0.001). Conclusion: Better hepatic function, such as mALBI grade 1 or 2a are thought to indicate a better condition for obtaining sufficient prognosis with Atez/Bev treatment for u-HCC patients, whereas for CP-B patients, who mainly shown an mALBI grade of 2b or 3, Atez/Bev might have less therapeutic efficacy.
KW - Child-Pugh class B
KW - atezolizumab plus bevacizumab
KW - hepatocellular carcinoma
KW - modified albumin-bilirubin grade
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85133690747&partnerID=8YFLogxK
U2 - 10.1111/hepr.13797
DO - 10.1111/hepr.13797
M3 - 学術論文
C2 - 35633504
AN - SCOPUS:85133690747
SN - 1386-6346
VL - 52
SP - 773
EP - 783
JO - Hepatology Research
JF - Hepatology Research
IS - 9
ER -
