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. 2023;101(8):491-501.
doi: 10.1159/000530991. Epub 2023 Jul 10.

The Analysis of Muscle Volume Measured by Bioelectrical Impedance in Patients with Hepatocellular Carcinoma Treated with First-Line Atezolizumab plus Bevacizumab Combination Therapy or First-Line Lenvatinib

Kikukawa Chihiro  1   2 , Tomokazu Kawaoka  3   4 , Shinsuke Uchikawa  3   4 , Takahiro Kinami  3   4 , Shintaro Yamasaki  3   4 , Masanari Kosaka  3   4 , Yusuke Johira  3   4 , Shigeki Yano  3   4 , Kei Amioka  3   4 , Kensuke Naruto  3   4 , Yuwa Ando  3   4 , Kenji Yamaoka  3   4 , Yuji Teraoka  3   4 , Takuro Uchida  3   4 , Hatsue Fujino  3   4 , Takashi Nakahara  3   4 , Atsushi Ono  3   4 , Eisuke Murakami  3   4 , Wataru Okamoto  5 , Masami Yamauchi  3   4 , Daiki Miki  3   4 , Masataka Tsuge  3   4 , Michio Imamura  3   4 , Hiroshi Aikata  6 , Shiro Oka  3   4
Affiliations

The Analysis of Muscle Volume Measured by Bioelectrical Impedance in Patients with Hepatocellular Carcinoma Treated with First-Line Atezolizumab plus Bevacizumab Combination Therapy or First-Line Lenvatinib

Kikukawa Chihiro et al. Oncology. 2023.

Abstract

Introduction: Measurements of body composition, such as the skeletal muscle index (SMI), are useful for predicting prognosis in hepatocellular carcinoma (HCC). This study aimed to analyze the relationship between skeletal muscle changes during therapy with atezolizumab plus bevacizumab (Atezo + Beva) or lenvatinib (Len) and the association between SMI and prognosis.

Methods: Patients with advanced HCC and Child-Pugh A status received Atezo + Beva or Len as first-line systemic chemotherapy. We assessed prognosis and body composition obtained by bioelectrical impedance analysis.

Results: A total of 109 patients received treatment (Atezo + Beva, n = 47; Len, n = 62). During treatment, the arm SMI was reduced in the Len group and maintained in the Atezo + Beva group. The extracellular water to total body water ratio (ECW/TBW) increased significantly in both groups during treatment. In the Atezo + Beva group, no factor was associated with prognosis. Multivariate analysis showed that in the Len group, the arm SMI (hazard ratio [HR], 0.5; 95% CI: 0.26-0.89; p = 0.02), ECW/TBW (HR: 2.7; 95% CI: 1.21-6.01; p = 0.01), and Child-Pugh score (HR: 2.3; 95% CI: 1.31-6.13; p = 0.004) were associated with progression-free survival.

Conclusion: Assessing body composition with BIA before Atezo + Beva and Len treatment may be useful.

Keywords: Atezolizumab; Bevacizumab; Hepatocellular carcinoma; Lenvatinib; Skeletal muscle mass index.

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