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Evaluation of Response to Atezolizumab Plus Bevacizumab in Patients with Advanced Hepatocellular Carcinoma Using the Combination of Response Evaluation Criteria in Solid Tumors and Alpha-Fetoprotein

SIMPLE SUMMARY: Hepatocellular carcinoma (HCC) is reportedly the fifth most common malignancy in the world. Atezolizumab plus bevacizumab combination therapy (Atezo + Beva) was approved in 2020 as the first immune-combined therapy and the standard of care for first-line systemic treatment of unresec...

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Autores principales: Kinami, Takahiro, Amioka, Kei, Kawaoka, Tomokazu, Uchikawa, Shinsuke, Yamasaki, Shintaro, Kosaka, Masanari, Johira, Yusuke, Yano, Shigeki, Naruto, Kensuke, Ando, Yuwa, Yamaoka, Kenji, Fujii, Yasutoshi, Fujino, Hatsue, Nakahara, Takashi, Ono, Atsushi, Murakami, Eisuke, Okamoto, Wataru, Yamauchi, Masami, Miki, Daiki, Tsuge, Masataka, Imamura, Michio, Aikata, Hiroshi, Oka, Shiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10137288/
https://www.ncbi.nlm.nih.gov/pubmed/37190231
http://dx.doi.org/10.3390/cancers15082304
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author Kinami, Takahiro
Amioka, Kei
Kawaoka, Tomokazu
Uchikawa, Shinsuke
Yamasaki, Shintaro
Kosaka, Masanari
Johira, Yusuke
Yano, Shigeki
Naruto, Kensuke
Ando, Yuwa
Yamaoka, Kenji
Fujii, Yasutoshi
Fujino, Hatsue
Nakahara, Takashi
Ono, Atsushi
Murakami, Eisuke
Okamoto, Wataru
Yamauchi, Masami
Miki, Daiki
Tsuge, Masataka
Imamura, Michio
Aikata, Hiroshi
Oka, Shiro
author_facet Kinami, Takahiro
Amioka, Kei
Kawaoka, Tomokazu
Uchikawa, Shinsuke
Yamasaki, Shintaro
Kosaka, Masanari
Johira, Yusuke
Yano, Shigeki
Naruto, Kensuke
Ando, Yuwa
Yamaoka, Kenji
Fujii, Yasutoshi
Fujino, Hatsue
Nakahara, Takashi
Ono, Atsushi
Murakami, Eisuke
Okamoto, Wataru
Yamauchi, Masami
Miki, Daiki
Tsuge, Masataka
Imamura, Michio
Aikata, Hiroshi
Oka, Shiro
author_sort Kinami, Takahiro
collection PubMed
description SIMPLE SUMMARY: Hepatocellular carcinoma (HCC) is reportedly the fifth most common malignancy in the world. Atezolizumab plus bevacizumab combination therapy (Atezo + Beva) was approved in 2020 as the first immune-combined therapy and the standard of care for first-line systemic treatment of unresectable HCC. Alpha-fetoprotein (AFP) is the most widely used serum biomarker in HCC. Although some studies have shown the benefit and safety of Atezo + Beva, there are no reports on when to switch from Atezo + Beva to the next treatment, and this is not yet clear. This study investigated the relationship between radiological response and prognosis in patients assessed as having stable disease (SD) in whom it is necessary to decide whether to continue Atezo + Beva. The results showed that a decreased AFP level may reflect early efficacy, and AFP trends could help determine whether to continue Atezo + Beva in patients assessed as having SD. ABSTRACT: Atezolizumab plus bevacizumab combination therapy (Atezo + Beva) is currently positioned as the first-line therapy for unresectable hepatocellular carcinoma (u-HCC). It may be difficult to decide whether to continue this treatment if radiological response is assessed as stable disease (SD). Therefore, the relationship between radiological response and prognosis was analyzed. A total of 109 patients with u-HCC and Child–Pugh Score of 5–7 received this treatment. Radiological response was assessed using Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST at the first and second evaluations. Of SD patients (n = 71) at the first RECIST evaluation, partial response, SD, and progressive disease (PD) were seen in 10, 55, and 6 patients, respectively, at the second evaluation. On multivariate analysis, in patients with SD at the first RECIST evaluation, a 25% or greater increase in the alpha-fetoprotein (AFP) value from initiation of treatment (odds ratio, 7.38; p = 0.037) was the independent factor for PD at the second evaluation. In patients with SD (n = 59) at the second RECIST evaluation, decreased AFP from initiation of treatment (hazard ratio, 0.46; p = 0.022) was the independent factor related to progression-free survival on multivariate analysis. AFP trends could help decide the Atezo + Beva treatment strategy.
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spelling pubmed-101372882023-04-28 Evaluation of Response to Atezolizumab Plus Bevacizumab in Patients with Advanced Hepatocellular Carcinoma Using the Combination of Response Evaluation Criteria in Solid Tumors and Alpha-Fetoprotein Kinami, Takahiro Amioka, Kei Kawaoka, Tomokazu Uchikawa, Shinsuke Yamasaki, Shintaro Kosaka, Masanari Johira, Yusuke Yano, Shigeki Naruto, Kensuke Ando, Yuwa Yamaoka, Kenji Fujii, Yasutoshi Fujino, Hatsue Nakahara, Takashi Ono, Atsushi Murakami, Eisuke Okamoto, Wataru Yamauchi, Masami Miki, Daiki Tsuge, Masataka Imamura, Michio Aikata, Hiroshi Oka, Shiro Cancers (Basel) Article SIMPLE SUMMARY: Hepatocellular carcinoma (HCC) is reportedly the fifth most common malignancy in the world. Atezolizumab plus bevacizumab combination therapy (Atezo + Beva) was approved in 2020 as the first immune-combined therapy and the standard of care for first-line systemic treatment of unresectable HCC. Alpha-fetoprotein (AFP) is the most widely used serum biomarker in HCC. Although some studies have shown the benefit and safety of Atezo + Beva, there are no reports on when to switch from Atezo + Beva to the next treatment, and this is not yet clear. This study investigated the relationship between radiological response and prognosis in patients assessed as having stable disease (SD) in whom it is necessary to decide whether to continue Atezo + Beva. The results showed that a decreased AFP level may reflect early efficacy, and AFP trends could help determine whether to continue Atezo + Beva in patients assessed as having SD. ABSTRACT: Atezolizumab plus bevacizumab combination therapy (Atezo + Beva) is currently positioned as the first-line therapy for unresectable hepatocellular carcinoma (u-HCC). It may be difficult to decide whether to continue this treatment if radiological response is assessed as stable disease (SD). Therefore, the relationship between radiological response and prognosis was analyzed. A total of 109 patients with u-HCC and Child–Pugh Score of 5–7 received this treatment. Radiological response was assessed using Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST at the first and second evaluations. Of SD patients (n = 71) at the first RECIST evaluation, partial response, SD, and progressive disease (PD) were seen in 10, 55, and 6 patients, respectively, at the second evaluation. On multivariate analysis, in patients with SD at the first RECIST evaluation, a 25% or greater increase in the alpha-fetoprotein (AFP) value from initiation of treatment (odds ratio, 7.38; p = 0.037) was the independent factor for PD at the second evaluation. In patients with SD (n = 59) at the second RECIST evaluation, decreased AFP from initiation of treatment (hazard ratio, 0.46; p = 0.022) was the independent factor related to progression-free survival on multivariate analysis. AFP trends could help decide the Atezo + Beva treatment strategy. MDPI 2023-04-14 /pmc/articles/PMC10137288/ /pubmed/37190231 http://dx.doi.org/10.3390/cancers15082304 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kinami, Takahiro
Amioka, Kei
Kawaoka, Tomokazu
Uchikawa, Shinsuke
Yamasaki, Shintaro
Kosaka, Masanari
Johira, Yusuke
Yano, Shigeki
Naruto, Kensuke
Ando, Yuwa
Yamaoka, Kenji
Fujii, Yasutoshi
Fujino, Hatsue
Nakahara, Takashi
Ono, Atsushi
Murakami, Eisuke
Okamoto, Wataru
Yamauchi, Masami
Miki, Daiki
Tsuge, Masataka
Imamura, Michio
Aikata, Hiroshi
Oka, Shiro
Evaluation of Response to Atezolizumab Plus Bevacizumab in Patients with Advanced Hepatocellular Carcinoma Using the Combination of Response Evaluation Criteria in Solid Tumors and Alpha-Fetoprotein
title Evaluation of Response to Atezolizumab Plus Bevacizumab in Patients with Advanced Hepatocellular Carcinoma Using the Combination of Response Evaluation Criteria in Solid Tumors and Alpha-Fetoprotein
title_full Evaluation of Response to Atezolizumab Plus Bevacizumab in Patients with Advanced Hepatocellular Carcinoma Using the Combination of Response Evaluation Criteria in Solid Tumors and Alpha-Fetoprotein
title_fullStr Evaluation of Response to Atezolizumab Plus Bevacizumab in Patients with Advanced Hepatocellular Carcinoma Using the Combination of Response Evaluation Criteria in Solid Tumors and Alpha-Fetoprotein
title_full_unstemmed Evaluation of Response to Atezolizumab Plus Bevacizumab in Patients with Advanced Hepatocellular Carcinoma Using the Combination of Response Evaluation Criteria in Solid Tumors and Alpha-Fetoprotein
title_short Evaluation of Response to Atezolizumab Plus Bevacizumab in Patients with Advanced Hepatocellular Carcinoma Using the Combination of Response Evaluation Criteria in Solid Tumors and Alpha-Fetoprotein
title_sort evaluation of response to atezolizumab plus bevacizumab in patients with advanced hepatocellular carcinoma using the combination of response evaluation criteria in solid tumors and alpha-fetoprotein
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10137288/
https://www.ncbi.nlm.nih.gov/pubmed/37190231
http://dx.doi.org/10.3390/cancers15082304
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