Impact of body mass index in patients receiving atezolizumab plus bevacizumab for hepatocellular carcinoma

被引：19

作者：

Vithayathil, Mathew ^{[1
]}

D'Alessio, Antonio ^{[1
,2
]}

Fulgenzi, Claudia Angela Maria ^{[1
,3
]}

Nishida, Naoshi ^{[4
]}

Schoenlein, Martin ^{[5
]}

von Felden, Johann ^{[6
]}

Schulze, Kornelius ^{[6
]}

Wege, Henning ^{[6
]}

Saeed, Anwaar ^{[7
]}

Wietharn, Brooke ^{[7
]}

Hildebrand, Hannah ^{[7
]}

Wu, Linda ^{[8
]}

Ang, Celina ^{[8
]}

Marron, Thomas U. ^{[8
]}

Weinmann, Arndt ^{[9
]}

Galle, Peter R. ^{[9
]}

Bettinger, Dominik ^{[10
]}

Bengsch, Bertram ^{[10
,11
,12
,13
]}

Vogel, Arndt ^{[14
]}

Balcar, Lorenz ^{[15
]}

Scheiner, Bernhard ^{[15
]}

Lee, Pei-Chang ^{[16
]}

Huang, Yi-Hsiang ^{[16
,17
]}

Amara, Suneetha ^{[18
]}

Muzaffar, Mahvish ^{[18
]}

Naqash, Abdul Rafeh ^{[18
,19
]}

Cammarota, Antonella ^{[2
,20
]}

Zanuso, Valentina ^{[2
,20
]}

Pressiani, Tiziana ^{[20
]}

Pinter, Matthias ^{[15
]}

Cortellini, Alessio ^{[1
]}

Kudo, Masatoshi ^{[4
]}

Rimassa, Lorenza ^{[2
,20
]}

Pinato, David J. ^{[1
,21
]}

Sharma, Rohini ^{[1
]}

机构：

[1] Imperial Coll London, Dept Surg & Canc, Hammersmith Campus,Du Cane Rd, London W12 0HS, England

[2] Humanitas Univ, Dept Biomed Sci, Milan, Italy

[3] Policlin Univ Campus Biomed, Div Med Oncol, Rome, Italy

[4] Kindai Univ, Fac Med, Dept Gastroenterol & Hepatol, Osaka, Japan

[5] Univ Med Ctr Hamburg Eppendorf, Dept Oncol Hematol & Bone Marrow Transplantat, Sect Pneumol, Hamburg, Germany

[6] Univ Med Ctr Hamburg Eppendorf, Dept Gastroenterol & Hepatol, Hamburg, Germany

[7] Kansas Univ, Canc Ctr, Dept Med, Div Med Oncol, Kansas City, KS USA

[8] Mt Sinai Hosp, Tisch Canc Inst, Dept Med, Div Hematol Oncol, New York, NY USA

[9] Univ Med Ctr Mainz, Med Dept 1, Mainz, Germany

[10] Univ Freiburg, Freiburg Univ Med Ctr, Fac Med, Dept Med Gastroenterol Hepatol Endocrinol & Infec, Freiburg, Germany

[11] Univ Freiburg, Signalling Res Ctr BIOSS, Freiburg, Germany

[12] Univ Freiburg, Signalling Res Ctr CIBSS, Freiburg, Germany

[13] German Canc Consortium DKTK, Partner Site, Freiburg, Germany

[14] Hannover Med Sch, Hannover, Germany

[15] Med Univ Vienna, Dept Internal Med 3, Div Gastroenterol & Hepatol, Vienna, Austria

[16] Taipei Vet Gen Hosp, Dept Med, Div Gastroenterol & Hepatol, Taipei, Taiwan

[17] Natl Yang Ming Chiao Tung Univ, Sch Med, Inst Clin Med, Taipei, Taiwan

[18] East Carolina Univ, Div Hematol Oncol, Greenville, NC USA

[19] Univ Oklahoma, Stephenson Canc Ctr, Med Oncol TSET Phase 1 Program, Norman, OK USA

[20] IRCCS Humanitas Res Hosp, Humanitas Canc Ctr, Med Oncol & Hematol Unit, Milan, Italy

[21] Univ Piemonte Orientale, Dept Translat Med, Div Oncol, Novara, Italy

来源：

HEPATOLOGY INTERNATIONAL | 2023年 / 17卷 / 04期

关键词：

Immunotherapy; Anti-programmed death-ligand; Anti-vascular endothelial growth factor; Checkpoint inhibitor; Obesity; Cirrhosis; Overall survival; Progression-free survival; Overweight; Non-alcoholic fatty liver disease; SORAFENIB; OBESITY; CANCER; CHEMOTHERAPY; ASSOCIATION; OUTCOMES; THERAPY; LIVER; INFLAMMATION; METAANALYSIS;

D O I：

10.1007/s12072-023-10491-3

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background Atezolizumab plus bevacizumab (Atezo/Bev) is first line-treatment for unresectable hepatocellular carcinoma (HCC). Body mass index (BMI) has demonstrated predictive value for response to immunotherapy in non-HCC cancer types. Our study investigated the effect of BMI on safety and efficacy of real-life use of Atezo/Bev for unresectable HCC. Methods 191 consecutive patients from seven centres receiving Atezo/Bev were included in the retrospective study. Overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and disease control rate (DCR) defined by RECIST v1.1 were measured in overweight (BMI >= 25) and non-overweight (BMI < 25) patients. Treatment-related adverse events (trAEs) were evaluated. Results Patients in the overweight cohort (n = 94) had higher rates of non-alcoholic fatty liver disease (NAFLD) and lower rates of Hepatitis B compared to non-overweight cohort (n = 97). Baseline Child-Pugh class and Barcelona Clinic Liver Cancer stage were similar between cohorts, with lower rates of extrahepatic spread in the overweight group. Overweight patients had similar OS compared to non-overweight (median OS 15.1 vs. 14.9 months; p = 0.99). BMI did not influence median PFS (7.1 vs. 6.1 months; p = 0.42), ORR (27.2% vs. 22.0%; p = 0.44) and DCR (74.1% vs. 71.9%; p = 0.46). There were higher rates of atezolizumab-related fatigue (22.3% vs. 10.3%; p = 0.02) and bevacizumab-related thrombosis (8.5% vs. 2.1%; p = 0.045) in the overweight patients, but overall trAEs and treatment discontinuation were comparable between cohorts. Conclusion Atezo/Bev has comparable efficacy in overweight HCC patients, with an increase in treatment-related fatigue and thrombosis. Combination therapy is safe and efficacious to use in overweight patients, including those with underlying NAFLD.

引用

页码：904 / 914

页数：11

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