Efficacy of Atezolizumab Plus Bevacizumab–Transcatheter Arterial Chemoembolization Sequential Therapy for Patients with Intermediate-Stage Hepatocellular Carcinoma
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Patients
2.2. Assessment of Hepatic Reserve Function
2.3. Atez/Bev Treatment Protocol
2.4. Evaluation of Therapeutic Efficacy of Atez/Bev Treatment
2.5. Atez/Bev-TACE Sequential Therapy
2.6. TACE Treatment Protocol
2.7. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Swimmer Plot Analysis Assessment by Investigator Assessment
3.3. Best Therapeutic Response of Atez/Bev-TACE Sequential Therapy According to mRECIST Criteria
3.4. PFS after TACE and Comparison of PFS between Patients with and without Atez/Bev Administration after TACE
3.5. Changes in the ALBI Score in the Atez/Bev-TACE Sequential Treatment Group
3.6. Patient Characteristics in Patients with Intermediate-Stage HCC
3.7. Comparison of OS between Atez/Bev and Atez/Bev-TACE Sequential Therapy in the Whole Sample and in Patients with Intermediate-Stage HCC
3.8. Univariate and Multivariate Analyses of Factors Associated with OS in Patients with Intermediate-Stage HCC
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Response Category | m-RECIST |
---|---|
CR | 6 (26.1%) |
PR | 11 (47.8%) |
SD | 2 (8.7%) |
PD | 4 (17.3%) |
ORR | 17 (73.9%) |
DCR | 19 (82.6%) |
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Characteristic | All Patients | Atez/ Bev-TACE | Atez/Bev | p |
---|---|---|---|---|
n | 212 | 23 | 189 | |
Age (years old) | 73 (37–93) | 69 (50–84) | 73 (37–93) | 0.255 |
Sex (female/male) | 45/167 | 5/18 | 40/149 | 0.893 |
PS (0/1/) | 182/30 | 19/4 | 163/26 | 0.636 |
Body Mass Index (kg/m2) | 23.0 (15.9–35.3) | 23.9 (15.4–35.3) | 23.1 (15.9–35.2) | 0.091 |
Etiology (viral/non-viral) | 126/86 | 12/11 | 114/75 | 0.452 |
ALBI score (Median (range)) | −2.44 (−3.50–−1.55) | −2.45 (−2.96–−1.71) | −2.44 (−3.50–−1.55) | 0.964 |
mALBI grade (1/2a/2b) | 71/76/65 | 10/6/7 | 61/70/58 | 0.483 |
BCLC stage (A/B/C) | 2/109/101 | 1/18/4 | 1/91/97 | 0.003 |
tumor size (mm) | 32 (10–136) | 26 (11–132) | 32.0 (10–136) | 0.255 |
Number of tumors <5/≥5 | 74/138 | 9/14 | 65/124 | 0.652 |
Macrovascular invasion (No/Yes) | 173/39 | 21/2 | 152/37 | 0.203 |
Extrahepatic spread (No/Yes) | 140/72 | 20/3 | 120/69 | 0.016 |
AFP (ng/mL) | 32.1 (1.2–284, 543) | 6.4 (1.4–1167) | 36.5 (1.2–209, 295) | 0.082 |
Number of Atez/Bev cycles before TACE | 7 (5–19) | n.s | ||
Treatment line (first-line/later-lines) | 143/69 | 13/10 | 130/59 | 0.236 |
Characteristic | All Patients | Atez/Bev-TACE | Atez/Bev | p |
---|---|---|---|---|
n | 109 | 18 | 91 | |
Age (years old) | 74 (50–93) | 71 (50–84) | 75 (51–93) | 0.219 |
Sex (female/male) | 24/85 | 5/13 | 19/72 | 0.518 |
Body Mass Index (kg/m2) | 23.0 (16.6–35.3) | 23.2 (19.5–29.6) | 23.0 (16.6–35.2) | 0.641 |
Etiology (viral/non-viral) | 62/47 | 11/7 | 51/40 | 0.691 |
ALBI score (Median (range)) | −2.46 (−3.50–−1.59) | −2.47 (−2.92–−1.70) | −2.44 (−3.50–−1.59) | 0.873 |
mALBI grade (1/2a/2b) | 38/35/36 | 8/4/6 | 30/31/30 | 0.542 |
Up-to-seven (in/out) | 23/86 | 4/14 | 19/72 | 0.895 |
tumor size (mm) | 32 (10–136) | 25.0 (11–132) | 30.0 (10–136) | 0.285 |
Number of tumors <5/≥5 | 36/73 | 7/11 | 29/62 | 0.562 |
AFP (ng/mL) | 11.4 (1.2–129, 743) | 10.7 (1.4–1167) | 11.4 (1.2–129, 743) | 0.725 |
Number of Atez/Bev cycles before TACE | 10 (6–19) | |||
Treatment line (first-line/later-lines) | 74/35 | 11/7 | 63/28 | 0.500 |
Variable | Univariate Analysis | Multivariate Analysis | ||
---|---|---|---|---|
p-Value | Odds Ratio | 95% CI | p-Value | |
Age, <70 vs. ≥70 | 0.615 | |||
Sex, female vs. male | 0.800 | |||
Etiology, viral vs. non-viral | 0.355 | |||
mALBI grade, 1 or 2a vs. 2b | <0.001 | 0.311 | 0.175–0.553 | <0.001 |
Up-to-seven (in/out) | 0.048 | 0.729 | 0.353–1.502 | 0.391 |
Number of tumors, <5 vs. ≥5 | 0.881 | |||
Tumor size, <30 vs. ≥30 | 0.017 | 0.696 | 0.385–1.256 | 0.228 |
AFP, <400 vs. ≥400 ng/mL | 0.001 | 0.228 | 0.116–0.449 | <0.001 |
Treatment line, (first-line vs. later-lines) | 0.094 | |||
Atez/Bev-TACE sequential, (+/−) | 0.015 | 0.311 | 0.138–0.702 | 0.001 |
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Moriyama, E.; Shimose, S.; Niizeki, T.; Iwamoto, H.; Tanaka, M.; Shirono, T.; Noda, Y.; Nakano, M.; Kuromatsu, R.; Koga, H.; et al. Efficacy of Atezolizumab Plus Bevacizumab–Transcatheter Arterial Chemoembolization Sequential Therapy for Patients with Intermediate-Stage Hepatocellular Carcinoma. Curr. Oncol. 2024, 31, 5821-5831. https://doi.org/10.3390/curroncol31100432
Moriyama E, Shimose S, Niizeki T, Iwamoto H, Tanaka M, Shirono T, Noda Y, Nakano M, Kuromatsu R, Koga H, et al. Efficacy of Atezolizumab Plus Bevacizumab–Transcatheter Arterial Chemoembolization Sequential Therapy for Patients with Intermediate-Stage Hepatocellular Carcinoma. Current Oncology. 2024; 31(10):5821-5831. https://doi.org/10.3390/curroncol31100432
Chicago/Turabian StyleMoriyama, Etsuko, Shigeo Shimose, Takashi Niizeki, Hideki Iwamoto, Masatoshi Tanaka, Tomotake Shirono, Yu Noda, Masahito Nakano, Ryoko Kuromatsu, Hironori Koga, and et al. 2024. "Efficacy of Atezolizumab Plus Bevacizumab–Transcatheter Arterial Chemoembolization Sequential Therapy for Patients with Intermediate-Stage Hepatocellular Carcinoma" Current Oncology 31, no. 10: 5821-5831. https://doi.org/10.3390/curroncol31100432