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Observational Study
. 2023 Feb;12(3):2646-2657.
doi: 10.1002/cam4.5145. Epub 2022 Aug 14.

Initial therapeutic results of atezolizumab plus bevacizumab for unresectable advanced hepatocellular carcinoma and the importance of hepatic functional reserve

Tetsu Tomonari  1 , Joji Tani  2 , Yasushi Sato  3 , Hironori Tanaka  1 , Takahiro Tanaka  1 , Tatsuya Taniguchi  1 , Morishita Asahiro  2 , Koichi Okamoto  1 , Masahiro Sogabe  1 , Hiroshi Miyamoto  1 , Naoki Muguruma  1 , Tsutomu Masaki  2 , Tetsuji Takayama  1
Affiliations
Observational Study

Initial therapeutic results of atezolizumab plus bevacizumab for unresectable advanced hepatocellular carcinoma and the importance of hepatic functional reserve

Tetsu Tomonari et al. Cancer Med. 2023 Feb.

Abstract

Aim: We analyzed the association between the modified albumin-bilirubin (mALBI) grade and therapeutic efficacy of atezolizumab plus bevacizumab (Atezo+Bev) for the treatment of unresectable hepatocellular carcinoma (u-HCC).

Methods: In this retrospective observational study, we included 71 u-HCC patients treated with Atezo+Bev between September 2020 and September 2021. Patients were grouped corresponding to the mALBI grade at the start of treatment (mALBI 1+2a or mALBI 2b+3) and analyzed for therapeutic effect and the transition rate to secondary treatment.

Results: According to the Response Evaluation Criteria in Solid Tumors, the overall response rate was significantly higher for the mALBI 1+2a group, than for the mALBI 2b+3 group, with 26.2% and 3.4%, respectively. The progression-free survival (PFS) was significantly longer in the mALBI 1+2a group (10.5 months) than in the mALBI 2b+3 group (3.0 months). In the multivariate analysis, an mALBI of 1+2a was found to be an independent factor of PFS. The rate of second-line treatment with multi-targeted agents was also significantly higher in the mALBI 1+2a group.

Conclusions: In real-world practice, Atezo+Bev treatment might have higher therapeutic efficacy in u-HCC patients with mALBI 1+2a.

Keywords: atezolizumab; bevacizumab; hepatocellular carcinoma.

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Conflict of interest statement

The authors declare no competing interest.

Figures

FIGURE 1
FIGURE 1
The progression‐free survival of all 71 patients treated with atezolizumab + bevacizumab analyzed using Kaplan–Meier curve.
FIGURE 2
FIGURE 2
Kaplan–Meier curves for progression‐free survival in atezolizumab plus bevacizumab‐treated patients stratified by mALBI Grade. There was a statistically significant difference between the mALBI 1+2a group and the mALBI 2b+3 group.
FIGURE 3
FIGURE 3
The transition of hepatic functional reserve after the administration of treatment with atezolizumab+bevacizumab at baseline, 3, 6, and 9 weeks.
FIGURE 4
FIGURE 4
(A) The transition of hepatic functional reserve in mALBI 1+2a after the introduction of treatment with atezolizumab+bevacizumab at baseline, 3, 6, and 9 weeks. (B) The transition of hepatic functional reserve in mALBI 2b+3 after the introduction of treatment with atezolizumab+bevacizumab at baseline, 3, 6, and 9 weeks.
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