Predictive factors and survival outcome of conversion therapy for unresectable hepatocellular carcinoma patients receiving atezolizumab and bevacizumab: Comparative analysis of conversion, partial response and complete response patients

医学 内科学 阿替唑单抗 肝细胞癌 贝伐单抗 胃肠病学 多元分析 阶段(地层学) 回顾性队列研究 肿瘤科 癌症 免疫疗法 化疗 生物 古生物学 彭布罗利珠单抗
作者
Takeshi Hatanaka,Satoru Kakizaki,Atsushi Hiraoka,Toshifumi Tada,Masashi Hirooka,Kazuya Kariyama,Joji Tani,Masanori Atsukawa,Koichi Takaguchi,Ei Itobayashi,Shinya Fukunishi,Kunihiko Tsuji,Toru Ishikawa,Kazuto Tajiri,Hidenori Toyoda,Chikara Ogawa,Hiroki Nishikawa,Takashi Nishimura,Kazuhito Kawata,Hisashi Kosaka,Atsushi Naganuma,Yutaka Yata,Hideko Ohama,Hidekatsu Kuroda,Tomomitsu Matono,Tomoko Aoki,Yuki Kanayama,Kazunari Tanaka,Fujimasa Tada,Kazuhiro Nouso,Asahiro Morishita,Akemi Tsutsui,Takuya Nagano,Norio Itokawa,Tomomi Okubo,Taeang Arai,Michitaka Imai,Shinichiro Nakamura,Hirayuki Enomoto,Masaki Kaibori,Yoichi Hiasa,Masatoshi Kudo,Takashi Kumada
出处
期刊:Alimentary Pharmacology & Therapeutics [Wiley]
被引量:2
标识
DOI:10.1111/apt.18237
摘要

Summary Aim This study aims to investigate the predictive factors for conversion therapy in patients with unresectable hepatocellular carcinoma (uHCC) and to evaluate the prognosis of conversion cases by comparing them with partial response (PR) and complete response (CR) cases. Methods In this retrospective multicentre study, we included a total of 946 uHCC patients treated with atezolizumab and bevacizumab (Atez/Bev) from September 2020 to September 2023. Results Out of the patients, 43 (4.5%) received conversion therapy following Atez/Bev treatment. The overall response rate was 65.1% and 23.7% in the conversion and non‐conversion group, respectively, with a statistical significance ( p < 0.001). Multivariate analyses identified that BCLC stage B or an earlier stage ( p = 0.045), absence of macrovascular invasion and extrahepatic spread ( p = 0.045), and a low value of neutrophil to lymphocyte ratio ( p = 0.04) were significantly favourable predictive factors associated with conversion therapy. The conversion group showed significantly better survival compared to the non‐conversion group ( p < 0.001). In the landmark analysis at 6, 12 and 18 months, the conversion group exhibited better survival compared to PR patients in the non‐conversion group ( p = 0.04, 0.01 and 0.03, respectively) and there were no significant differences in the overall survival (OS) between the conversion group and patients who achieved a CR ( p = 0.7, 1.0 and 0.3, respectively). Conclusions Patients with low tumour burden and low value of NLR were more likely to undergo conversion therapy. The OS of patients undergoing conversion therapy showed better survival compared to those achieving PR and was comparable to those with CR patients. Conversion therapy could be considered if feasible.
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