The impact of curative conversion therapy aimed at a cancer-free state in patients with hepatocellular carcinoma treated with atezolizumab plus bevacizumab

被引：22

作者：

Shimose, Shigeo ^{[1
]}

Iwamoto, Hideki ^{[1
,2
]}

Shirono, Tomotake ^{[1
]}

Tanaka, Masatoshi ^{[3
]}

Niizeki, Takashi ^{[1
]}

Kajiwara, Masahiko ^{[4
]}

Itano, Satoshi ^{[5
]}

Yano, Yoichi ^{[6
]}

Matsugaki, Satoru ^{[7
]}

Moriyama, Etsuko ^{[1
]}

Noda, Yu ^{[1
]}

Nakano, Masahito ^{[1
]}

Kuromatsu, Ryoko ^{[1
]}

Koga, Hironori ^{[1
]}

Kawaguchi, Takumi ^{[1
]}

机构：

[1] Kurume Univ, Dept Med, Div Gastroenterol, Sch Med, 67 Asahi Machi, Kurume, Fukuoka 8300011, Japan

[2] Iwamoto Internal Med Clin, Kitakyushu, Japan

[3] Yokokura Hosp, Clin Res Ctr, Miyama, Fukuoka, Japan

[4] Chikugo City Hosp, Dept Gastroenterol, Chikugo, Japan

[5] Kurume Cent Hosp, Dept Gastroenterol, Kurume, Japan

[6] Japan Community Hlth Care Org, Saga Cent Hosp, Dept Med, Div Gastroenterol, Saga, Japan

[7] Tobata Kyoritsu Hosp, Dept Gastroenterol, Kitakyushu, Japan

来源：

CANCER MEDICINE | 2023年 / 12卷 / 11期

关键词：

atezolizumab plus bevacizumab; conversion therapy; hepatocellular carcinoma; LIVER METASTASES; CRITERIA; SURVIVAL;

D O I：

10.1002/cam4.5931

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background and Aims: We aimed to validate the predictive factors for tumor response and the prognostic impact of conversion therapy aimed at cancer- and drug-free states in patients with unresectable hepatocellular carcinoma (u-HCC) undergoing atezolizumab plus bevacizumab (Atez/Bev) therapy. Methods: This retrospective study enrolled 156 patients who were Child-Pugh class A with u-HCC treated using Atez/Beva. The profile of objective response was investigated using decision-tree analysis. Progression-free, recurrence-free, and overall survival were assessed. Results: The progression-free and overall survival were 6.1 and 18.0 months, respectively. Objective response and disease control rates were 32.0% and 84.0%, respectively. Decision-tree analysis revealed that neutrophil-to-lymphocyte ratio (NLR) <3, modified albumin-bilirubin grade (m-ALBI) 1 or 2a, and age < 75 were sequential splitting variables for the objective response, respectively. In the multivariate analysis, NLR <3 and m-ALBI grade 1 or 2a were identified as predictive factors for objective response. We successfully achieved eligibility for conversion therapy in 17 patients after Atez/Bev therapy significant response. Following conversion therapy, the curative therapy group, including surgical resection or radiofrequency ablation (RFA), had significantly higher recurrence-free survival than did the transcatheter arterial chemoembolization (TACE) and Atez/Bev discontinuation (surgical resection or RFA; not reached vs. TACE; 5.3 months, p = 0.008, Atez/Bev discontinuation; 3.9 months, p = 0.048, respectively) groups. Conclusions: NLR <3 and m-ALBI grade 1 or 2a were predictive factors for conversion therapy, leading to cancer- and drug-free states in patients with u-HCC undergoing Atez/Bev therapy. Moreover, surgery or RFA may be suitable for conversion therapy for cancer-free status.

引用

页码：12325 / 12335

页数：11

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