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Pretreatment Neutrophil-to-Lymphocyte Ratio as a Predictive Marker of Response to Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma

1
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
2
Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2021, 28(5), 4157-4166; https://doi.org/10.3390/curroncol28050352
Received: 14 September 2021 / Revised: 12 October 2021 / Accepted: 13 October 2021 / Published: 14 October 2021
(This article belongs to the Special Issue Hepatobiliary Malignancies: Recent Advancements and Future Directions)
Background: Combination therapy with anti-programmed death-ligand 1 monoclonal antibody atezolizumab plus anti-vascular endothelial growth factor agent bevacizumab (Atezo/Bev) was approved in 2020 as a first-line treatment for unresectable hepatocellular carcinoma (HCC). Atezo/Bev therapy is relatively well tolerated; however, factors that can predict its response have not yet been reported. Thus, we aimed to investigate whether the pretreatment neutrophil-to-lymphocyte ratio (NLR) could predict the therapeutic response in patients with HCC treated with Atezo/Bev therapy. Methods: We analyzed the course of 40 patients with HCC who received Atezo/Bev therapy at our hospital and attempted to identify pretreatment factors that could predict response by comparing those who achieved disease control with those who did not. Results: The pretreatment NLR value in patients who achieved disease control was significantly lower than that in patients with disease progression (2.47 vs. 4.48, p = 0.013). Using the optimal NLR cut-off value for predicting response (3.21) determined by receiver operating characteristic curve analysis, patients with NLR ≤ 3.21 had significantly better progression-free survival than those with NLR > 3.21 (p < 0.0001), although there were no significant differences in liver function or tumor-related background factors between the two groups. Conclusions: The pretreatment NLR value may be a useful predictor of response to Atezo/Bev therapy for HCC. View Full-Text
Keywords: atezolizumab; bevacizumab; hepatocellular carcinoma; immune checkpoint inhibitor; vascular endothelial growth factor; neutrophil-to-lymphocyte ratio atezolizumab; bevacizumab; hepatocellular carcinoma; immune checkpoint inhibitor; vascular endothelial growth factor; neutrophil-to-lymphocyte ratio
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MDPI and ACS Style

Eso, Y.; Takeda, H.; Taura, K.; Takai, A.; Takahashi, K.; Seno, H. Pretreatment Neutrophil-to-Lymphocyte Ratio as a Predictive Marker of Response to Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma. Curr. Oncol. 2021, 28, 4157-4166. https://doi.org/10.3390/curroncol28050352

AMA Style

Eso Y, Takeda H, Taura K, Takai A, Takahashi K, Seno H. Pretreatment Neutrophil-to-Lymphocyte Ratio as a Predictive Marker of Response to Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma. Current Oncology. 2021; 28(5):4157-4166. https://doi.org/10.3390/curroncol28050352

Chicago/Turabian Style

Eso, Yuji, Haruhiko Takeda, Kojiro Taura, Atsushi Takai, Ken Takahashi, and Hiroshi Seno. 2021. "Pretreatment Neutrophil-to-Lymphocyte Ratio as a Predictive Marker of Response to Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma" Current Oncology 28, no. 5: 4157-4166. https://doi.org/10.3390/curroncol28050352

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