Efficacy of Atezolizumab Plus Bevacizumab Versus Lenvatinib in Patients with Unresectable Hepatocellular Carcinoma: a Meta-analysis

Changez, Mah I Kan; Khan, Maimoona; Uzair, Muhammad; Tahir, Muhammad Fawad; Mohsin, Maryam; Hussain, Amna Faiyaz; Saqib, Vania; Molani, Muhammad Khizer; Ahmed, Aisha Habib; Khalid, Saad

doi:10.1007/s12029-023-00999-0

Cited by 2 publications

References 28 publications

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Comparing Health Insurance-ReimbursedFirst Line Lenvatinib and Self-paid Atezolizumab plus Bevacizumab in Patients with Unresectable Hepatocellular Carcinoma

Kuo,

Chen,

Tsai

et al. 2024

Preprint

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Background/Purpose: Atezolizumab plus bevacizumab (Ate/Bev) and lenvatinib (Len) are first-line therapies for unresectable hepatocellular carcinoma (uHCC). However, Ate/Bev's high cost limits its common use in real-life practice, while Len is usually covered by national health insurance (NHI). We conducted this study to compare their effectiveness and safety in real-world settings. Methods: We retrospectively evaluated 346 uHCC patients treated with first-line Ate/Bev (n=80) or Len (n=266) from December 2019 to December 2022, using 1:2 ratio propensity score matching (PSM) analyses. Results: Compared to the Len group, the Ate/Bev group exhibited higher incidences of Child-Pugh class B (14.1% vs. 5.7%, p=0.014), larger main tumors (58.8% vs. 40.2%, p=0.003), and more main portal vein invasion (25% vs. 12.8%, p=0.008). Treatment-related adverse events were notably lower in the Ate/Bev group (56.3% vs. 72.3%, p=0.007). After PSM, no significant differences were observed in the objective response rate (21.9% vs. 21.6%, p=0.983), progression-free survival (5.1 vs. 6 months, p=0.783), and overall survival (13.3 vs. 14.1 months, p=0.945) between the Ate/Bev (n=73) and Len (n=142) groups. Patients in the Ate/Bev group received more sequential post-treatments compared to the Len group (45.2% vs. 24.6%, p=0.009). Len-based therapies (n=28, 84.8%) and mono- or combined-immunotherapy (n=19, 54.3%) were the most frequently administered sequential therapies following Ate/Bev and Len, respectively. Conclusion: Patients with uHCC who received first-line self-paid Ate/Bev appeared to have lower liver function reserve and more advanced tumor characteristics compared to those who underwent NHI-reimbursed Len. However, the treatment outcomes and safety profiles were similar between these two groups.

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Comparing Health Insurance-ReimbursedFirst Line Lenvatinib and Self-paid Atezolizumab plus Bevacizumab in Patients with Unresectable Hepatocellular Carcinoma

Kuo,

Chen,

Tsai

et al. 2024

Preprint

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Transarterial chemoembolization combined with lenvatinib plus tislelizumab for unresectable hepatocellular carcinoma: a multicenter cohort study

Zhao,

Wen,

Xue

et al. 2024

Front. Immunol.

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ObjectiveComparing the efficacy of transarterial chemoembolization (TACE) combined with lenvatinib plus tislelizumab (TLT) with TACE combined with lenvatinib (TL) for unresectable hepatocellular carcinoma, particularly in determining which patients can benefit more from the TLT treatment.MethodsFrom March 2021 to September 2023, a total of 169 patients from three centers were included in this study, with 103 patients receiving TLT and 66 patients receiving TL. The Kaplan-Meier method was utilized to evaluate the cumulative overall survival (OS) and progression-free survival (PFS) between the two groups and were assessed using the log-rank test. Subgroup analysis on tumor number, maximum tumor diameter, presence of portal vein thrombosis, AFP level, and Child-Pugh class were conducted.ResultsThe median OS was 26 months in the TLT group, and 20 months in the TL group. The median PFS was 14 months in the TLT group and 9 months in the TL group. The Kaplan-Meier curve demonstrated a significantly superior OS and PFS in the TLT group compared to the TL group. Subgroup analysis showed that for patients with a maximum tumor diameter greater than 7 cm, AFP > 400 ng/ml and accompanied by portal vein tumor thrombus, and Child-Pugh class A, there was a statistically significant difference in OS between TLT and TL groups.ConclusionsOS and PFS were significantly improved in patients who received TLT compared to those who received TL, patients with a largest tumor diameter greater than 7 cm, AFP > 400 ng/ml, Child-Pugh class A and PVTT appeared to derive more benefit.

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Efficacy of Atezolizumab Plus Bevacizumab Versus Lenvatinib in Patients with Unresectable Hepatocellular Carcinoma: a Meta-analysis

Cited by 2 publications

References 28 publications

Comparing Health Insurance-ReimbursedFirst Line Lenvatinib and Self-paid Atezolizumab plus Bevacizumab in Patients with Unresectable Hepatocellular Carcinoma

Comparing Health Insurance-ReimbursedFirst Line Lenvatinib and Self-paid Atezolizumab plus Bevacizumab in Patients with Unresectable Hepatocellular Carcinoma

Transarterial chemoembolization combined with lenvatinib plus tislelizumab for unresectable hepatocellular carcinoma: a multicenter cohort study

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