Clinical Usefulness of Monitoring Muscle Volume during Atezolizumab Plus Bevacizumab Therapy in Patients with Unresectable Hepatocellular Carcinoma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Treatment Protocol
2.3. Image Analysis
2.4. Statistical Analysis
3. Results
3.1. Overall Efficacy and Safety Data
3.2. The Association between SMI Decrease and Treatment Efficacy
3.3. The Association between SMI Decrease and Adverse Events during Atezolizumab Plus Bevacizumab Therapy
3.4. The Association between Presarcopenia and Clinical Outcome
3.5. The Factors Associated with PFS after Administration of Atezolizumab Plus Bevacizumab
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | N = 32 |
---|---|
Sex: Male/Female (%) | Modified ALBI grade: 1/2a/2b/3 (%) |
19 (59)/13 (41) | 11 (34)/7 (22)/14 (44)/0 (0) |
Age (years), median (range) | BCLC stage B/C (%) |
77 (54–91) | 24 (75)/8 (25) |
Height (m2), median (range) | Presarcopenia Yes/No (%) |
1.6 (1.3–1.9) | 14 (44)/18 (56) |
Body weight (kg), median (range) | Major vascular invasion Yes/No (%) |
59.5 (37.3–87.0) | 4 (12)/28 (88) |
Etiology HBV/HCV/ALD/NAFLD (%) | Extrahepatic metastasis Yes/No (%) |
4 (12)/15 (47)/5 (16)/8 (25) | 4 (12)/28 (88) |
ECOG PS 0/1/2 (%) | CRP (mg/dL), median (range) |
18 (56)/14 (44)/0 (0) | 0.25 (0.030–8.8) |
Child–Pugh A/B (%) | AFP (ng/mL), median (range) |
30 (94)/2 (6) | 182.0 (1.60–41,246.2) |
ALBI score: median (range) | PIVKAⅡ (AU/mL), median (range) |
−2.32 (−3.28∼−1.47) | 259.9 (15.0–313,273.7) |
Variable | With SMI Decrease (N = 17) | Without SMI Decrease (N = 15) | p |
---|---|---|---|
Sex: Male/Female (%) | 9 (53)/8 (47) | 10 (67)/5 (33) | 0.49 |
Age (years): median (range) | 80 (56–91) | 73 (54–86) | 0.012 |
Height (m): median (range) | 1.6 (1.3–1.8) | 1.6 (1.4–1.9) | 0.36 |
Body weight (kg): median (range) | 57.2 (40.7–82.5) | 60.0 (37.3–87.0) | 0.27 |
Etiology HBV/HCV/ALD/NAFLD (%) | 2 (12)/8 (47)/3 (18)/4 (23) | 2 (13)/7 (47)/2 (13)/4 (27) | 0.70 |
Child–Pugh A/B (%) | 17 (100)/0 (0) | 13 (87)/2 (13) | 0.21 |
Pretreatment mALBI score: median (range) | −2.42 (−3.27~−1.71) | −2.23 (−3.28~−1.47) | 0.18 |
Presarcopenia Yes/No (%) | 5 (29)/12 (71) | 9 (60)/6 (40) | 0.15 |
Discontinuation or reduction of bevacizumab (%) | 4 (25)/12 (75) | 5 (33)/10 (67) | 0.70 |
Major vascular invasion Yes/No (%) | 3 (18)/14 (82) | 1 (7)/14 (93) | 0.60 |
Albumin (g/dL), median (range) | 3.7 (3.0–4.8) | 3.5 (2.8–4.7) | 0.29 |
Total Bilirubin (mg/dL), median (range) | 0.7 (0.40–1.6) | 0.9 (0.5–1.7) | 0.17 |
CRP (mg/dL), median (range) | 0.27 (0.080–2.7) | 0.20 (0.030–8.8) | 0.21 |
NH3 (μg/dL), median (range) | 35 (12–83) | 50 (17–136) | 0.05 |
AFP (ng/mL), median (range) | 355.5 (2.2–41,246.2) | 21.9 (1.6–4323.6) | 0.18 |
PIVKAⅡ (AU/mL), median (range) | 339.2 (15.4–313,273.7) | 144.5 (15.0–13,385.4) | 0.84 |
Variable | With SMI Decrease (N = 17) | Without SMI Decrease (N = 15) | p |
---|---|---|---|
CR | 0 | 2 | |
PR | 3 | 5 | |
SD | 8 | 7 | |
PD | 6 | 1 | |
ORR | 17.6% | 46.7% | 0.13 |
DCR | 64.7% | 93.3% | 0.088 |
Variable | Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|---|
HR | 95% CI | p | HR | 95% CI | p | |
sex | 0.95 | 0.34–2.68 | 0.92 | |||
Age (years) | 1.0 | 0.94–1.1 | 0.80 | |||
ALD | 1.8 | 0.49–6.5 | 0.38 | |||
Child-Pugh score | 0.76 | 0.33–1.7 | 0.51 | |||
Major vascular invasion | 0.48 | 0.063–3.7 | 0.48 | |||
Extrahepatic metastasis | 5.4 | 1.56–18.9 | 0.0079 | 1.8 | 0.26–12.1 | 0.57 |
Presarcopenia | 1.1 | 0.40–3.1 | 0.84 | |||
SMI decrease | 4.6 | 1.3–16.6 | 0.020 | 5.1 | 1.0–21.4 | 0.025 |
BCLC stage C | 2.9 | 1.0–8.2 | 0.047 | 1.3 | 0.28–6.4 | 0.72 |
Baseline CRP (mg/dL) | 1.3 | 1.0–1.6 | 0.033 | 1.4 | 1.0–1.9 | 0.052 |
Baseline AFP ≥ 400 (ng/mL) | 1.4 | 0.42–4.3 | 0.61 |
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Matsumoto, H.; Tsuchiya, K.; Nakanishi, H.; Hayakawa, Y.; Yasui, Y.; Uchihara, N.; Suzuki, K.; Tanaka, Y.; Miyamoto, H.; Ishido, S.; et al. Clinical Usefulness of Monitoring Muscle Volume during Atezolizumab Plus Bevacizumab Therapy in Patients with Unresectable Hepatocellular Carcinoma. Cancers 2022, 14, 3551. https://doi.org/10.3390/cancers14143551
Matsumoto H, Tsuchiya K, Nakanishi H, Hayakawa Y, Yasui Y, Uchihara N, Suzuki K, Tanaka Y, Miyamoto H, Ishido S, et al. Clinical Usefulness of Monitoring Muscle Volume during Atezolizumab Plus Bevacizumab Therapy in Patients with Unresectable Hepatocellular Carcinoma. Cancers. 2022; 14(14):3551. https://doi.org/10.3390/cancers14143551
Chicago/Turabian StyleMatsumoto, Hiroaki, Kaoru Tsuchiya, Hiroyuki Nakanishi, Yuka Hayakawa, Yutaka Yasui, Naoki Uchihara, Keito Suzuki, Yuki Tanaka, Haruka Miyamoto, Shun Ishido, and et al. 2022. "Clinical Usefulness of Monitoring Muscle Volume during Atezolizumab Plus Bevacizumab Therapy in Patients with Unresectable Hepatocellular Carcinoma" Cancers 14, no. 14: 3551. https://doi.org/10.3390/cancers14143551