Selection of Systemic Treatment Regimen for Unresectable Hepatocellular Carcinoma: Does Etiology Matter?

Kudo, Masatoshi

doi:10.1159/000525467

Cited by 7 publications

(5 citation statements)

References 21 publications

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“…18 However, this trend was not confirmed in the present study. Notably, there have been several reports stating that ICIs are more likely to be effective in NASH-HCC when combined with a molecular-targeted agent, such as bevacizumab, 19 which was consistent with the results in this study. The usefulness of the chronological measurement of AFP as a predictor of response to atezolizumab plus bevacizumab therapy has also been reported.…”

Section: Patient Characteristicssupporting

confidence: 92%

The prediction of early progressive disease in patients with hepatocellular carcinoma receiving atezolizumab plus bevacizumab

et al. 2023

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Background and AimsThe IMbrave 150 trial revealed the usefulness of atezolizumab plus bevacizumab therapy in patients with unresectable hepatocellular carcinoma (HCC), making it now considered the first‐line systemic chemotherapy agent for HCC. The present study investigated factors associated with early tumor progression of atezolizumab plus bevacizumab in patients with advanced HCC in real‐world clinical practice.MethodsA total of 184 HCC patients who received atezolizumab plus bevacizumab therapy were studied. We investigated the frequency of early progressive disease (e‐PD; PD within 9 weeks) and analyzed the risk factors for e‐PD.ResultsThere were 47 patients (25.5%) diagnosed as e‐PD. Patients with e‐PD had a worse performance status (PS) and albumin–bilirubin (ALBI) and Child‐Pugh (C‐P) scores and a significantly higher rate of a systemic therapy than those with non‐e‐PD. A multivariate analysis showed that PS ≥1 (odds ratio [OR] = 4.5, 95% confidence interval [CI] = 1.9–10, p < 0.001), ALBI score ≥−2.30 (OR = 2.1, 95% CI = 1.0–4.5, p = 0.044) and the history of a systemic therapy (OR = 3.0, 95% CI = 1.4–6.4, p = 0.0038) were significant and independent determinants of e‐PD. When examining the liver function trends in e‐PD patients, the ALBI scores at 3 and 6 weeks after starting therapy were significantly higher than before the treatment (p < 0.001).ConclusionsThe liver function and systemic therapy are useful predictors of e‐PD in HCC patients treated with atezolizumab plus bevacizumab in real‐world clinical practice.

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Section: Patient Characteristicssupporting

confidence: 92%

The prediction of early progressive disease in patients with hepatocellular carcinoma receiving atezolizumab plus bevacizumab

et al. 2023

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“…Other previous reports have shown consistent results with our study [33,34]. Notably, a previous report stated that ICIs are more likely to be effective in NASH-HCC when combined with a molecular-targeted agent, such as bevacizumab [35].…”

Section: Discussionsupporting

confidence: 92%

Peripheral T Cell Subpopulations as a Potential Surrogate Biomarker during Atezolizumab plus Bevacizumab Treatment for Hepatocellular Carcinoma

Shirane,

Fujii,

Ono

et al. 2024

Cancers

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The therapeutic benefits of the immunotherapeutic combination of atezolizumab and bevacizumab (Atez/Bev) in hepatocellular carcinoma (HCC) vary. Therapeutic biomarkers might help improve outcomes for HCC patients receiving Atez/Bev therapy. The role of systemic immune profiles in HCC progression also remains unclear. This study aimed to evaluate the status and dynamics of peripheral T cell subpopulations in HCC patients receiving Atez/Bev treatment and to explore biomarkers predictive of a therapeutic response. We enrolled 83 unresectable advanced HCC patients who commenced Atez/Bev treatment at our hospital between October 2020 and June 2022. Peripheral T cell subpopulations in peripheral blood mononuclear cells at baseline and 3 weeks post-treatment were investigated using flow cytometry and compared with those in control samples from 18 healthy individuals. We retrospectively analyzed the association between peripheral T cell subpopulation profiles and clinical outcomes. Baseline peripheral T cell subpopulations could be profiled in 70 patients with sufficient cell counts, among whom 3-week subpopulations could be evaluated in 51 patients. Multivariate analysis showed that a high baseline proportion of CD8+ central memory T (TCM) cells was independently associated with longer progression-free survival (PFS). Further, overall survival (OS) was significantly prolonged in patients with increased CD8+ effector memory T (TEM) cell proportions. In conclusion, TCM proportion at baseline might be a good indicator of the efficacy of Atez/Bev therapy. Furthermore, observation of increasing TEM proportions might be an early predictor of the potential clinical benefits of treatment.

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“…NASH-HCC is one portion of non-viral HCC, but the exact etiology is not stated in most clinical trials, including the IMbrave050 trial. However, it has been clear that, unlike immune checkpoint inhibitor (ICI) monotherapy, Atezo/ Bev is equally effective regardless of etiology [12][13][14] in advanced HCC. Similarly, it was revealed that adjuvant Atezo/Bev was effective in curatively treating HCC in terms of suppression of recurrence in non-viral etiology.…”

Section: Results Of the Imbrave050 Trialmentioning

confidence: 99%

Selection of Systemic Treatment Regimen for Unresectable Hepatocellular Carcinoma: Does Etiology Matter?

Abstract: NA

Cited by 7 publications

References 21 publications

The prediction of early progressive disease in patients with hepatocellular carcinoma receiving atezolizumab plus bevacizumab

The prediction of early progressive disease in patients with hepatocellular carcinoma receiving atezolizumab plus bevacizumab

Peripheral T Cell Subpopulations as a Potential Surrogate Biomarker during Atezolizumab plus Bevacizumab Treatment for Hepatocellular Carcinoma

Adjuvant Atezolizumab-Bevacizumab after Resection or Ablation for Hepatocellular Carcinoma

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