The prognostic role of tumour progression and liver function at progression under immunotherapy for hepatocellular carcinoma

Cabibbo, Giuseppe; Edeline, Julien

doi:10.1111/liv.15513

Cited by 2 publications

(4 citation statements)

References 22 publications

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“…Unfortunately, most studies included in the meta-analysis did not report the causes of death, and thus it was not possible to provide a definite answer to these important clinical questions. It is worth emphasizing that preserving, and possibly improving, liver function is of essence in patients with HCC not only to enhance their likelihood of access to oncological treatments, but also to support their activity by increasing liver disease-related life expectancy [6,40].…”

Section: Discussionmentioning

confidence: 99%

“…As preservation of liver function is a critical component when determining treatment options and tolerability, those patients with decompensated disease are often not eligible for various therapies. Whatever the cause of decompensation, patients with HCC who are Child-Pugh class B represent an extremely heterogeneous and difficult-to-treat population for which the survival benefit obtained by the treatment of liver cancer is often hampered by the risk of impending, unresolvable decompensation [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…In patients with unresectable HCC, presence of vascular invasion, extrahepatic spread, or lack of eligibility for locoregional treatment are considered indications for systemic treatment and these characteristics are prevalent among Child-Pugh class B patients with HCC. Indeed, more than half of the Child-Pugh class B patients included in the Korean Primary Liver Cancer Registry were classified as BCLC stage C due to these oncological characteristics, and in these patients, overall survival (OS) with systemic therapy was 3 months [4][5][6][7][8][9]. Unfortunately, systemic treatment of Child-Pugh class B patients may be challenging, and these patients are usually not included in prospective trials.…”

Section: Introductionmentioning

confidence: 99%

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Safety and Efficacy of Atezolizumab/Bevacizumab in Patients with Hepatocellular Carcinoma and Impaired Liver Function: A Systematic Review and Meta-Analysis

Pasta,

Calabrese,

Jaffe

et al. 2023

Liver Cancer

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BACKGROUND: Safety and outcome of atezolizumab/bevacizumab in Child-Pugh B patients with hepatocellular carcinoma (HCC) have not been completely characterized. OBJECTIVES: In this study we aimed at addressing safety and efficacy of atezolizumab/bevacizumab in Child-Pugh B patients by reviewing the available data and analysing them by meta-analysis. METHOD: We compared the safety and efficacy of atezolizumab/becavizumab treatment in patients with unresectable HCC and various degrees of liver dysfunction. A total of 8 retrospective, non-randomized, cohort studies were included in this meta-analysis, for a total of 1,071 Child-Pugh A and 225 Child-Pugh B patients. The albumin-bilirubin (ALBI) grade was also used to assess liver function, when available. RESULTS: Grade ≥3 adverse events were observed in 11.8% of Child-Pugh class A and 26.8% class B patients (P=0.0001), with an Odds Ratio (OR) of 0.43 [confidence interval (CI) 0.21–0.90; P=0.02). Progression Free Survival (PFS) at both 6-month (4.90±2.08 vs 4.75±2.08 months; P=0.0004) and 12-month (8.83±2.32 vs 7.26±2.33 months; P=0.002) was lower in Child-Pugh class B patients. A trend towards higher objective response rate (ORR) was observed in Child-Pugh class A patients (219/856, 25.6%) as compared to Child-Pugh class B patients (25/138, 18.1%; P=0.070), while the probability of obtaining an ORR was significantly greater in Child-Pugh A patients (OR 1.79, CI 1.12–2.86; P=0.02). Median overall survival (OS) was 16.8±2.0 and 6.8±3.2 months in Child-Pugh A and B patients, respectively (mean difference 9.06 months, CI 7.01–11.1, P<0.0001). Lastly, OS was longer in patients with ALBI grade 1-2 than in those with grade 3 (8.3±11.4 versus 3.3±5.0 months, P=0.0008). CONCLUSIONS: Oncological efficacy of atezolizumab/bevacizumab is moderate in Child-Pugh class B patients, and the shorter PFS and OS associated with the greater likelihood of experiencing treatment-related adverse events observed in these patients suggest great caution and individualization of treatment, possibly with the support of the ALBI grade.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Safety and Efficacy of Atezolizumab/Bevacizumab in Patients with Hepatocellular Carcinoma and Impaired Liver Function: A Systematic Review and Meta-Analysis

Pasta,

Calabrese,

Jaffe

et al. 2023

Liver Cancer

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“…HCC mainly affects patients with advanced liver fibrosis or cirrhosis, indicating that liver function impairment significantly impacts prognosis (25). The albumin-bilirubin (ALBI) score, a simplified method for assessing liver function in HCC patients, categorizes patients into grades 1-3, with grade 1 representing the least liver damage (26).…”

Section: Albi Scorementioning

confidence: 99%

Biomarkers predicting the efficacy of immune checkpoint inhibitors in hepatocellular carcinoma

Qin,

Jin,

2023

Front. Immunol.

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In recent years, immune checkpoint inhibitors (ICIs) have emerged as a transformative approach in treating advanced hepatocellular carcinoma (HCC). Despite their success, challenges persist, including concerns about their effectiveness, treatment costs, frequent occurrence of treatment-related adverse events, and tumor hyperprogression. Therefore, it is imperative to identify indicators capable of predicting the efficacy of ICIs treatment, enabling optimal patient selection to maximize clinical benefits while minimizing unnecessary toxic side effects and economic losses. This review paper categorizes prognostic biomarkers of ICIs treatment into the following categories: biochemical and cytological indicators, tumor-related markers, imaging and personal features, etiology, gut microbiome, and immune-related adverse events (irAEs). By organizing these indicators systematically, we aim to guide biomarker exploration and inform clinical treatment decisions.

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The prognostic role of tumour progression and liver function at progression under immunotherapy for hepatocellular carcinoma

Cited by 2 publications

References 22 publications

Safety and Efficacy of Atezolizumab/Bevacizumab in Patients with Hepatocellular Carcinoma and Impaired Liver Function: A Systematic Review and Meta-Analysis

Safety and Efficacy of Atezolizumab/Bevacizumab in Patients with Hepatocellular Carcinoma and Impaired Liver Function: A Systematic Review and Meta-Analysis

Biomarkers predicting the efficacy of immune checkpoint inhibitors in hepatocellular carcinoma

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