Analysis of Factors Predicting the Real-World Efficacy of Atezolizumab and Bevacizumab in Patients with Advanced Hepatocellular Carcinoma
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Background/Aims: Atezolizumab and bevacizumab have shown promising results for the treatment of advanced hepatocellular carcinoma (HCC) in clinical trials. In this study, the real-world efficacy and safety of atezolizumab and bevacizumab in treating advanced HCC were evaluated. Methods: In this retrospective study of patients at a Korean tertiary cancer center, 111 patients with Barcelona Clinic Liver Cancer stage B or C HCC received atezolizumab and bevacizumab as first-line therapy from May 2022 to June 2023. We assessed the progression-free survival (PFS), overall response rate (ORR), disease control rate (DCR), and adverse events. Results: Patients with Barcelona Clinic Liver Cancer stage C HCC and Child-Pugh class A liver function were included in the study. The median PFS was 6.5 months, with an ORR of 27% and a DCR of 63%. Several factors, including the albumin-bilirubin grade, age, C-reactive protein and α-fetoprotein in immunotherapy score, macrovascular invasion, lung metastases, and combined radiotherapy, were found to significantly influence PFS (p<0.05). Patients with peritoneal seeding showed an higher ORR. The safety profile was consistent with that observed in clinical trials. Conclusions: Atezolizumab and bevacizumab demonstrated real-world efficacy in the treatment of advanced HCC, with ORRs and DCRs aligning with those observed in clinical trials. Variations in PFS and ORR based on specific risk factors highlight the potential of atezolizumab and bevacizumab in precision medicine for advanced HCC.
Abstract
Background/Aims: Atezolizumab and bevacizumab have shown promising results for the treatment of advanced hepatocellular carcinoma (HCC) in clinical trials. In this study, the real-world efficacy and safety of atezolizumab and bevacizumab in treating advanced HCC were evaluated. Methods: In this retrospective study of patients at a Korean tertiary cancer center, 111 patients with Barcelona Clinic Liver Cancer stage B or C HCC received atezolizumab and bevacizumab as first-line therapy from May 2022 to June 2023. We assessed the progression-free survival (PFS), overall response rate (ORR), disease control rate (DCR), and adverse events. Results: Patients with Barcelona Clinic Liver Cancer stage C HCC and Child-Pugh class A liver function were included in the study. The median PFS was 6.5 months, with an ORR of 27% and a DCR of 63%. Several factors, including the albumin-bilirubin grade, age, C-reactive protein and α-fetoprotein in immunotherapy score, macrovascular invasion, lung metastases, and combined radiotherapy, were found to significantly influence PFS (p<0.05). Patients with peritoneal seeding showed an higher ORR. The safety profile was consistent with that observed in clinical trials. Conclusions: Atezolizumab and bevacizumab demonstrated real-world efficacy in the treatment of advanced HCC, with ORRs and DCRs aligning with those observed in clinical trials. Variations in PFS and ORR based on specific risk factors highlight the potential of atezolizumab and bevacizumab in precision medicine for advanced HCC.
참고문헌 (22)
- Sung H, "Global cancer statistics 2020 : GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries", CA Cancer J Clin, 71, pp.209~249 (2021)
- Ryerson AB, "Annual Report to the Nation on the Status of Cancer, 1975-2012, featuring the increasing incidence of liver cancer", Cancer, 122, pp.1312~1337 (2016)
- Tan D, "Meta-analysis : underutilisation and disparities of treatment among patients with hepatocellular carcinoma in the United States", Aliment Pharmacol Ther, 38, pp.703~712 (2013)
- Yang WJ, "The impact of socioeconomic status on mortality in patients with hepatocellular carcinoma : a Korean national cohort study", Gut Liver, 16, pp.976~984 (2022)
- Finn RS, "Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma", N Engl J Med, 382, pp.1894~1905 (2020)
- Cheng AL, "Updated efficacy and safety data from IMbrave150 : atezolizumab plus bevacizumab vs. sorafenib for unresectable hepatocellular carcinoma", J Hepatol, 76, pp.862~873 (2022)
- Kudo M, "Changing the treatment paradigm for hepatocellular carcinoma using atezolizumab plus bevacizumab combination therapy", Cancers(Basel), 13, pp.5475~ (2021)
- Korean Liver Cancer Association(KLCA)and National Cancer Center(NCC)Korea, "2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma", Clin Mol Hepatol, 28, pp.583~705 (2022)
- Shin J, "Diagnostic performance of LIRADS v2018 versus KLCA-NCC 2018 criteria for hepatocellular carcinoma using magnetic resonance imaging with hepatobiliary agent : a systematic review and meta-analysis of comparative studies", Gut Liver, 17, pp.466~474 (2023)
- Eisenhauer EA, "New response evaluation criteria in solid tumours : revised RECIST guideline(version 1. 1)", Eur J Cancer, 45, pp.228~247 (2009)
- Lencioni R, "Modified RECIST(mRECIST)assessment for hepatocellular carcinoma", Semin Liver Dis, 30, pp.52~60 (2010)
- Fulgenzi CAM, "Reproducible safety and efficacy of atezolizumab plus bevacizumab for HCC in clinical practice : results of the AB-real study", Eur J Cancer, 175, pp.204~213 (2022)
- Fujii J, "A case of multiple postoperative recurrence of hepatocellular carcinoma successfully treated with atezolizumab plus bevacizumab", Gan To Kagaku Ryoho, 50, pp.96~98 (2023)
- Cho Y, "A case of successful surgical treatment for peritoneal seeding of hepatocellular carcinoma after radiotherapy and atezolizumab plus bevacizumab combination treatment", J Liver Cancer, 23, pp.206~212 (2023)
- Scheiner B, "Prognosis of patients with hepatocellular carcinoma treated with immunotherapy : development and validation of the CRAFITY score", J Hepatol, 76, pp.353~363 (2022)
- Guan R, "Is the CRAFITY score a superior predictor of prognosis and adverse events in hepatocellular carcinoma patients treated with locoregionalimmunotherapy?", Hepatol Int, 17, pp.1279~1288 (2023)
- Khalid J, "Tumor aggression among hepatitis-C related hepatocellular carcinoma patients : an observational study regarding the impact of anti-HCV therapy", Infect Agent Cancer, 15, pp.35~ (2020)
- Zhan H, "Correlation and survival analysis of distant metastasis site and prognosis in patients with hepatocellular carcinoma", Front Oncol, 11, pp.652768~ (2021)
- Uchino K, "Hepatocellular carcinoma with extrahepatic metastasis : clinical features and prognostic factors", Cancer, 117, pp.4475~4483 (2011)
- Shao G, "Development and validation of a diagnostic and prognostic model for lung metastasis of hepatocellular carcinoma : a study based on the SEER database", Front Med(Lausanne), 10, pp.1171023~ (2023)
- Jost-Brinkmann F, "Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma : results from a German real-world cohort", Aliment Pharmacol Ther, 57, pp.1313~1325 (2023)
- Ouyang J, "The MAPS-CRAFITY score : a novel efficacy predictive tool for unresectable hepatocellular carcinoma treated with targeted therapy plus immunotherapy", Hepatol Int, 17, pp.1519~1531 (2023)