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Pretreatment Proteinuria Predicts the Prognosis of Patients Receiving Systemic Therapy for Unresectable Hepatocellular Carcinoma
SIMPLE SUMMARY: Proteinuria is a common adverse event of systemic therapy for hepatocellular carcinoma (HCC); however, its effect on clinical outcomes is not well understood. A retrospective analysis of 321 patients with unresectable HCC who received systemic therapy as first-line treatment was perf...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10216745/ https://www.ncbi.nlm.nih.gov/pubmed/37345189 http://dx.doi.org/10.3390/cancers15102853 |
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author | Mizuno, Kazuyuki Imai, Norihiro Yamamoto, Takafumi Yokoyama, Shinya Yamamoto, Kenta Ito, Takanori Ishizu, Yoji Honda, Takashi Kuzuya, Teiji Ishigami, Masatoshi Kawashima, Hiroki |
author_facet | Mizuno, Kazuyuki Imai, Norihiro Yamamoto, Takafumi Yokoyama, Shinya Yamamoto, Kenta Ito, Takanori Ishizu, Yoji Honda, Takashi Kuzuya, Teiji Ishigami, Masatoshi Kawashima, Hiroki |
author_sort | Mizuno, Kazuyuki |
collection | PubMed |
description | SIMPLE SUMMARY: Proteinuria is a common adverse event of systemic therapy for hepatocellular carcinoma (HCC); however, its effect on clinical outcomes is not well understood. A retrospective analysis of 321 patients with unresectable HCC who received systemic therapy as first-line treatment was performed to assess the impact of pretreatment proteinuria on treatment response. Patients without pretreatment proteinuria who received lenvatinib or atezolizumab plus bevacizumab had longer overall survival, but those treated with sorafenib did not. Additionally, a quantitative analysis of 111 patients treated with lenvatinib or atezolizumab plus bevacizumab revealed that the severity of proteinuria was an independent predictor of prognosis, along with liver function. Therefore, pretreatment proteinuria may predict a poorer prognosis in patients with unresectable HCC treated with lenvatinib or atezolizumab plus bevacizumab but not in those treated with sorafenib. ABSTRACT: Background: Proteinuria is a common adverse event in systemic therapy for hepatocellular carcinoma (HCC). However, whether the presence of pretreatment proteinuria affects the clinical course is still unclear. Method: From 2011 to 2022, 321 patients with unresectable HCC who were treated with systemic therapy as first-line treatment were enrolled in this study. We retrospectively analyzed the presence of pretreatment proteinuria and the treatment course of systemic therapy. Results: In the cohort, 190 patients were tested for proteinuria qualitatively within 3 months before systemic therapy; 75 were treated with sorafenib, 72 were treated with lenvatinib, and 43 were treated with atezolizumab plus bevacizumab. Overall survival tended to be longer for patients treated with lenvatinib and significantly longer with atezolizumab plus bevacizumab in patients without pretreatment proteinuria but not for those treated with sorafenib. Further analysis was performed in 111 patients treated with lenvatinib or atezolizumab plus bevacizumab who had proteinuria measured quantitatively. Multivariate analysis including proteinuria, liver function, and HCC stage revealed that the severity of proteinuria was an independent predictor of prognosis. Conclusion: Pretreatment proteinuria predicts a poorer prognosis in patients with unresectable HCC treated with lenvatinib or atezolizumab plus bevacizumab but not in those treated with sorafenib. |
format | Online Article Text |
id | pubmed-10216745 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-102167452023-05-27 Pretreatment Proteinuria Predicts the Prognosis of Patients Receiving Systemic Therapy for Unresectable Hepatocellular Carcinoma Mizuno, Kazuyuki Imai, Norihiro Yamamoto, Takafumi Yokoyama, Shinya Yamamoto, Kenta Ito, Takanori Ishizu, Yoji Honda, Takashi Kuzuya, Teiji Ishigami, Masatoshi Kawashima, Hiroki Cancers (Basel) Article SIMPLE SUMMARY: Proteinuria is a common adverse event of systemic therapy for hepatocellular carcinoma (HCC); however, its effect on clinical outcomes is not well understood. A retrospective analysis of 321 patients with unresectable HCC who received systemic therapy as first-line treatment was performed to assess the impact of pretreatment proteinuria on treatment response. Patients without pretreatment proteinuria who received lenvatinib or atezolizumab plus bevacizumab had longer overall survival, but those treated with sorafenib did not. Additionally, a quantitative analysis of 111 patients treated with lenvatinib or atezolizumab plus bevacizumab revealed that the severity of proteinuria was an independent predictor of prognosis, along with liver function. Therefore, pretreatment proteinuria may predict a poorer prognosis in patients with unresectable HCC treated with lenvatinib or atezolizumab plus bevacizumab but not in those treated with sorafenib. ABSTRACT: Background: Proteinuria is a common adverse event in systemic therapy for hepatocellular carcinoma (HCC). However, whether the presence of pretreatment proteinuria affects the clinical course is still unclear. Method: From 2011 to 2022, 321 patients with unresectable HCC who were treated with systemic therapy as first-line treatment were enrolled in this study. We retrospectively analyzed the presence of pretreatment proteinuria and the treatment course of systemic therapy. Results: In the cohort, 190 patients were tested for proteinuria qualitatively within 3 months before systemic therapy; 75 were treated with sorafenib, 72 were treated with lenvatinib, and 43 were treated with atezolizumab plus bevacizumab. Overall survival tended to be longer for patients treated with lenvatinib and significantly longer with atezolizumab plus bevacizumab in patients without pretreatment proteinuria but not for those treated with sorafenib. Further analysis was performed in 111 patients treated with lenvatinib or atezolizumab plus bevacizumab who had proteinuria measured quantitatively. Multivariate analysis including proteinuria, liver function, and HCC stage revealed that the severity of proteinuria was an independent predictor of prognosis. Conclusion: Pretreatment proteinuria predicts a poorer prognosis in patients with unresectable HCC treated with lenvatinib or atezolizumab plus bevacizumab but not in those treated with sorafenib. MDPI 2023-05-21 /pmc/articles/PMC10216745/ /pubmed/37345189 http://dx.doi.org/10.3390/cancers15102853 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 Mizuno, Kazuyuki Imai, Norihiro Yamamoto, Takafumi Yokoyama, Shinya Yamamoto, Kenta Ito, Takanori Ishizu, Yoji Honda, Takashi Kuzuya, Teiji Ishigami, Masatoshi Kawashima, Hiroki Pretreatment Proteinuria Predicts the Prognosis of Patients Receiving Systemic Therapy for Unresectable Hepatocellular Carcinoma |
title | Pretreatment Proteinuria Predicts the Prognosis of Patients Receiving Systemic Therapy for Unresectable Hepatocellular Carcinoma |
title_full | Pretreatment Proteinuria Predicts the Prognosis of Patients Receiving Systemic Therapy for Unresectable Hepatocellular Carcinoma |
title_fullStr | Pretreatment Proteinuria Predicts the Prognosis of Patients Receiving Systemic Therapy for Unresectable Hepatocellular Carcinoma |
title_full_unstemmed | Pretreatment Proteinuria Predicts the Prognosis of Patients Receiving Systemic Therapy for Unresectable Hepatocellular Carcinoma |
title_short | Pretreatment Proteinuria Predicts the Prognosis of Patients Receiving Systemic Therapy for Unresectable Hepatocellular Carcinoma |
title_sort | pretreatment proteinuria predicts the prognosis of patients receiving systemic therapy for unresectable hepatocellular carcinoma |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10216745/ https://www.ncbi.nlm.nih.gov/pubmed/37345189 http://dx.doi.org/10.3390/cancers15102853 |
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