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Disease Etiology Impact on Outcomes of Hepatocellular Carcinoma Patients Treated with Atezolizumab plus Bevacizumab: A Real-World, Multicenter Study.
Rossari, Federico; Tada, Toshifumi; Suda, Goki; Shimose, Shigeo; Kudo, Masatoshi; Yoo, Changhoon; Cheon, Jaekyung; Finkelmeier, Fabian; Lim, Ho Yeong; Presa, José; Masi, Gianluca; Bergamo, Francesca; Amadeo, Elisabeth; Vitiello, Francesco; Kumada, Takashi; Sakamoto, Naoya; Iwamoto, Hideki; Aoki, Tomoko; Chon, Hong Jae; Himmelsbach, Vera; Iavarone, Massimo; Cabibbo, Giuseppe; Montes, Margarida; Foschi, Francesco Giuseppe; Vivaldi, Caterina; Soldà, Caterina; Sho, Takuya; Niizeki, Takashi; Nishida, Naoshi; Steup, Christoph; Hirooka, Masashi; Kariyama, Kazuya; Tani, Joji; Atsukawa, Masanori; Takaguchi, Koichi; Itobayashi, Ei; Fukunishi, Shinya; Tsuji, Kunihiko; Ishikawa, Toru; Tajiri, Kazuto; Ochi, Hironori; Yasuda, Satoshi; Toyoda, Hidenori; Ogawa, Chikara; Nishimura, Takashi; Hatanaka, Takeshi; Kakizaki, Satoru; Shimada, Noritomo; Kawata, Kazuhito; Hiraoka, Atsushi.
Afiliación
  • Rossari F; Department of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy.
  • Tada T; San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy.
  • Suda G; Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan.
  • Shimose S; Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
  • Kudo M; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
  • Yoo C; Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan.
  • Cheon J; Department of Oncology, ASAN Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Finkelmeier F; Department of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
  • Lim HY; Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
  • Presa J; Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea.
  • Masi G; Liver Unit-CHTMAD, Vila Real, Portugal.
  • Bergamo F; Unit of Medical Oncology 2, University Hospital of Pisa, Pisa, Italy.
  • Amadeo E; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
  • Vitiello F; Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
  • Kumada T; Department of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy.
  • Sakamoto N; Department of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy.
  • Iwamoto H; Department of Nursing, Gifu Kyoritsu University, Ogaki, Japan.
  • Aoki T; Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
  • Chon HJ; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
  • Himmelsbach V; Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan.
  • Iavarone M; Department of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
  • Cabibbo G; Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
  • Montes M; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Division of Gastroenterology and Hepatology Milan, Milan, Italy.
  • Foschi FG; Section of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties PROMISE, University of Palermo, Palermo, Italy.
  • Vivaldi C; Liver Unit-CHTMAD, Vila Real, Portugal.
  • Soldà C; Department of Internal Medicine, Ospedale di Faenza, Faenza, Italy.
  • Sho T; Unit of Medical Oncology 2, University Hospital of Pisa, Pisa, Italy.
  • Niizeki T; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
  • Nishida N; Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
  • Steup C; Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
  • Hirooka M; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
  • Kariyama K; Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan.
  • Tani J; Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
  • Atsukawa M; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
  • Takaguchi K; Department of Gastroenterology, Okayama City Hospital, Okayama, Japan.
  • Itobayashi E; Department of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan.
  • Fukunishi S; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
  • Tsuji K; Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
  • Ishikawa T; Department of Gastroenterology, Asahi General Hospital, Asahi, Japan.
  • Tajiri K; Department of Gastroenterology, Osaka Medical and Pharmaceutical University, Osaka, Japan.
  • Ochi H; Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
  • Yasuda S; Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.
  • Toyoda H; Department of Gastroenterology, Toyama University Hospital, Toyama, Japan.
  • Ogawa C; Hepato-Biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Japan.
  • Nishimura T; Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
  • Hatanaka T; Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
  • Kakizaki S; Department of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Japan.
  • Shimada N; Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo Medical University, Nishinomiya, Japan.
  • Kawata K; Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan.
  • Hiraoka A; Department of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.
Liver Cancer ; 13(5): 522-536, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39296620
ABSTRACT

Introduction:

The impact of etiology on response to immunotherapy in advanced hepatocellular carcinoma (HCC) is being debated, with contrasting findings between early and recent post hoc analyses of IMbrave-150 and metanalyses of clinical trials of PD-1/PD-L1 blockers. As a results, it is not clear whether the first-line systemic treatment atezolizumab plus bevacizumab (A + B) is equally effective in viral and nonviral patients.

Methods:

We retrospectively analyzed 885 HCC patients treated with the first-line A + B from multiple centers from Eastern and Western countries, 53.9% having viral and 46.1% nonviral etiology. Baseline clinical and laboratory characteristics were analyzed with uni- and multivariate models to explore potential differences on overall survival (OS), time-to-progression (TTP), disease control rates (DCRs) based on etiology and to identify putative prognostic factors in etiology subgroups. Treatment toxicities and access to the second-line treatments and outcomes were also reported and compared between etiologies.

Results:

Overall, no statistically significant differences were found in median OS (mOS viral 15.9 months; nonviral 16.3 months), TTP (mTTP viral 8.3 months; nonviral 7.2 months), and DCRs (viral 78.1%; nonviral 80.8%) based on etiology. Prognostic factors of survival and progression were mainly shared between viral and nonviral etiologies, including alpha-fetoprotein, aspartate transaminase, neutrophil-to-lymphocyte ratio (NLR) and ALBI score. Exploratory analyses highlighted a possible stronger association of immunological factors, i.e., NLR and eosinophil count, to treatment outcomes in viral patients. The toxicity profile, the access to and type of the second-line treatments and their outcome in terms of OS almost overlap in the two etiology subgroups.

Conclusion:

Atezolizumab plus bevacizumab efficacy does not vary according to underlying etiology of HCC in a multicenter, real-world population, matching recent post hoc findings from the IMbrave-150 trial. Preliminary analyses suggest that some prognostic factors differ between viral and nonviral patients, potentially due to biological and immunological differences. Prospective and comparative trials stratifying by etiology are warranted to validate these findings and guide clinical practice.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Liver Cancer Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Liver Cancer Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza