Bevacizumab and atezolizumab as first-line therapy for advanced hepatocellular carcinoma: A Taiwanese subgroup analysis on efficacy and safety

Shao, Yu‐Yun; Feng, Yin‐Hsun; Yen, Chia‐Jui; Yang, Tsung‐Ming; Shen, Ying‐Chun; Chao, Yee; Chen, Jen‐Shi; Su, Ching-Yen; Chen, Wei-Jen; Hsiang, Hwa-Lin Liz; Hsu, Chih‐Hung

doi:10.1016/j.jfma.2022.09.005

Cited by 7 publications

(9 citation statements)

References 24 publications

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“…53 TLCA guidelines and clinical studies suggest that target therapy combined with TACE can be considered in highly selected patients with BCLC-B unresectable HCC with Child-Pugh A and ECOG 0-1. 10 16.6-not estimable), 55 which was consistent with the findings for the global intent-to-treat populations. Wu et al evaluated 71 patients who received lenvatinib plus pembrolizumab for unresectable HCC and reported an ORR of 34.1% in the first-line setting and 18.5% for systemic therapy-experienced cases.…”

Section: Clinical Guidelinessupporting

confidence: 84%

Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Taiwan perspective

Su¹,

Wu²,

Liu³

et al. 2023

Clin Mol Hepatol

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Hepatocellular carcinoma (HCC) is the fourth most common cancer and the second leading cause of cancer-related death in Taiwan. The Taiwan Liver Cancer Association and the Gastroenterological Society of Taiwan developed and updated the guidelines for HCC management in 2020. In clinical practice, we follow these guidelines and the reimbursement policy of the government. Abdominal ultrasonography, alpha-fetoprotein, and protein induced by vitamin K absence or antagonist-II (PIVKA-II) tests are performed for HCC surveillance every 6 months, which may be shortened to 3 months for highrisk patients. Dynamic computed tomography, magnetic resonance imaging, and contrast-enhanced ultrasound can be recommended for HCC surveillance in patients with extremely high-risk or poor ultrasonographic visualization results. HCC is usually diagnosed through dynamic imaging, and pathological diagnosis is recommended. The staging of HCC is based on a modified version of the Barcelona Clinic Liver Cancer (BCLC) system, and the HCC management guidelines in Taiwan actively promote curative treatments, including surgery and locoregional therapy for BCLC-B-C patients. Su et al. 4 Transarterial chemoembolization (TACE), drug-eluting bead TACE, radioembolization, and hepatic artery infusion chemotherapy may be administered for patients with BCLC-B-C HCC. Sorafenib and lenvatinib are reimbursed as systemic therapies, and regorafenib and ramucirumab can be reimbursed in cases of sorafenib failure. First-line atezolizumab with bevacizumab are not yet reimbursed but may be administered in clinical practice. Chemotherapy and external beam radiation therapy may be used in specific patients. Early switching to systemic therapy in TACE-refractory patients is a recent paradigm shift in HCC management.

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Section: Clinical Guidelinessupporting

confidence: 84%

Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Taiwan perspective

Su¹,

Wu²,

Liu³

et al. 2023

Clin Mol Hepatol

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“…Although PD-1 blockade is an effective treatment for HCC [ [32] , [33] ], the use of PD-1 inhibitors as a single agent does not provide superior survival benefits to those of antiangiogenic targeted therapy, such as sorafenib [ 3 , 4 , 31 ]. By contrast, the combination of antiangiogenic therapy or other immune checkpoint inhibitors with PD-1 inhibitors has demonstrated superior survival benefits to those of sorafenib [ [4] , [5] , [6] , 34 ]. Therefore, CDK9 inhibitors may constitute a promising candidate for such combination therapies.…”

Section: Discussionmentioning

confidence: 99%

Cyclin dependent kinase 9 inhibition reduced programmed death-ligand 1 expression and improved treatment efficacy in hepatocellular carcinoma

Shao,

Hsieh,

Lee

et al. 2024

Heliyon

Self Cite

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“…Post-progression treatment after Atez/Bev has not been established. Lenvatinib or sorafenib were empirically used as the second-line treatment after Atez/Bev in previous studies [18, 24]. A recent international observational study reported that ICI to TKI sequencing was a consolidated option in advanced HCC [40], and lenvatinib has been reported to be the most favorable second-line treatment after Atez/Bev due to its inhibitory mechanism for immunotherapy-resistant HCC [41].…”

Section: Discussionmentioning

confidence: 99%

“…Two were prospective studies, of which one was a global study [16] and one was a Thailand study [17]. The other 15 were retrospective studies including five global studies [18][19][20][21][22], two each from Taiwan [23,24], USA [25,26], Germany [27,28], and Japan [29,30], and one each from France [31] and Austria [32], see Table 1. In present study, Atez/Bev was administered as the first-line treatment in most of the cohorts (86.1%, online suppl.…”

Section: Association Between Os and Pps In Atez/bev Treatment: A Syst...mentioning

confidence: 99%

Objective Response and Progression-Free Survival Contribute to Prolong Overall Survival in Atezolizumab plus Bevacizumab Treatment for Unresectable Hepatocellular Carcinoma

Tajiri,

Tsukada,

Tokimitsu

et al. 2023

Oncology

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Introduction: Atezolizumab plus bevacizumab (Atez/Bev) is a standard treatment for unresectable hepatocellular carcinoma (HCC) due to its good antitumor and survival prolongation effects. Post-progression survival (PPS) has been reported to be a great contributor in the treatment with tyrosine kinase inhibitors for unresectable HCC. This study aimed to clarify the significance of progression-free survival (PFS) or PPS of Atez/Bev treatment for HCC. Methods: We analyzed the correlations of PFS and PPS with overall survival (OS) in studies of HCC patients treated with Atez/Bev and evaluated the contribution to OS in Atez/Bev treatment with patients at our institutions as clinical practice. Results: Analysis of 18 studies involving 3,752 patients treated with Atez/Bev found that PPS had a stronger correlation with OS (R2 = 0.872, p < 0.001) than did PFS (R2 = 0.605, p = 0.001). Analysis of 80 patients with unresectable HCC treated with Atez/Bev found that presence of antitumor responses during Atez/Bev was the most significant contributor to OS, and post-progression treatment after Atez/Bev also significantly contribute to OS. Conclusion: The presence of antitumor response with tumor shrinkage during Atez/Bev treatment contributes to good OS through its durable response. Atez/Bev treatment could be considered as first-line treatment for unresectable HCC. However, there is a need for optimal biomarkers for good antitumor response.

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Bevacizumab and atezolizumab as first-line therapy for advanced hepatocellular carcinoma: A Taiwanese subgroup analysis on efficacy and safety

Cited by 7 publications

References 24 publications

Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Taiwan perspective

Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Taiwan perspective

Cyclin dependent kinase 9 inhibition reduced programmed death-ligand 1 expression and improved treatment efficacy in hepatocellular carcinoma

Objective Response and Progression-Free Survival Contribute to Prolong Overall Survival in Atezolizumab plus Bevacizumab Treatment for Unresectable Hepatocellular Carcinoma

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