Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep 27;31(10):5821-5831.
doi: 10.3390/curroncol31100432.

Efficacy of Atezolizumab Plus Bevacizumab-Transcatheter Arterial Chemoembolization Sequential Therapy for Patients with Intermediate-Stage Hepatocellular Carcinoma

Etsuko Moriyama  1 , Shigeo Shimose  1 , Takashi Niizeki  1 , Hideki Iwamoto  1   2 , Masatoshi Tanaka  3 , Tomotake Shirono  1 , Yu Noda  1 , Masahito Nakano  1 , Ryoko Kuromatsu  1 , Hironori Koga  1 , Takumi Kawaguchi  1
Affiliations

Efficacy of Atezolizumab Plus Bevacizumab-Transcatheter Arterial Chemoembolization Sequential Therapy for Patients with Intermediate-Stage Hepatocellular Carcinoma

Etsuko Moriyama et al. Curr Oncol. .

Abstract

This retrospective study aimed to evaluate the impact of atezolizumab plus bevacizumab-transcatheter arterial chemoembolization (TACE) sequential therapy in unresectable hepatocellular carcinoma (HCC), especially in patients with intermediate-stage HCC. A total of 212 patients were enrolled and categorized into the Atez/Bev-TACE sequential therapy (n = 23) or Atez/Bev monotherapy group (n = 189) between 2020 and 2024. Of these, patients with intermediate-stage HCC were categorized into the Atez/Bev-TACE sequential (n = 18) or Atez/Bev monotherapy group (n = 91). The best objective response rate, disease control rate, and median progression-free survival (PFS) after TACE were 73.9%, 82.6%, and 6.1 months, respectively. The PFS after TACE was significantly higher in the Atez/Bev sequential therapy group than in the no-Atez/Bev-administration group after TACE (6.9 months vs. 5.0 months, p = 0.025). The median overall survival (OS) was significantly higher in the Atez/Bev-TACE sequential therapy group than in the Atez/Bev monotherapy group for intermediate-stage HCC (34.9 months vs. 17.8 months; p = 0.016). Independent factors associated with OS were low alpha-fetoprotein levels, modified albumin-bilirubin 1 or 2a levels, and Atez/Bev-TACE sequential therapy. Atez/Bev-TACE sequential therapy improved prognosis compared with Atez/Bev monotherapy in patients with intermediate-stage HCC. Moreover, Atez/Bev should be readministered after TACE.

Keywords: TACE; atezolizumab plus bevacizumab; hepatocellular carcinoma.

PubMed Disclaimer

Conflict of interest statement

Shigeo Shimose has received lecture fees from AstraZeneca and Eisai. Hideki Iwamoto has received lecture fees from Chugai Pharmaceutical Co., Ltd., and Eizai. Takumi Kawaguchi has received lecture fees from ASKA Pharmaceutical Co. Ltd.; Taisho Pharmaceutical Co. Ltd.; Kowa Company Ltd.; AbbVie GK.; Eisai Co. Ltd.; Novo Nordisk Pharma Ltd.; Janssen Pharmaceutical K.K.; Otsuka Pharmaceutical Co. Ltd.; and EA Pharma Co. Ltd. The authors have no conflicts of interest to declare.

Figures

Figure A1
Figure A1
Change in ALBI score from baseline to 4 weeks after TACE.
Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Swimmer plot of investigator assessment in the Atez/Bev-TACE sequential therapy group. Yellow triangles represent an Atez/Bev treatment cycle. Reddish-brown triangles represent TACE. Dark blue arrows represent ongoing treatment with Atez/Bev-TACE. Green triangles represent added TACE for achieving cancer-free status.
Figure 3
Figure 3
Kaplan–Meier curves for progression-free survival. (A) Progression-free survival from TACE. (B) Progression-free survival according to the administration of Atez/Bev after TACE. The red line indicates the administration of Atez/Bev after TACE. The blue line indicates no administration of Atez/Bev after TACE.
Figure 4
Figure 4
Overall survival time in patients with HCC treated with Atez/Bev. (A) Kaplan–Meier curves for overall survival in the Atez/Bev-TACE sequential therapy group and the Atez/Bev monotherapy group. (B) Kaplan–Meier curves for overall survival in the Atez/Bev-TACE sequential therapy group and the Atez/Bev monotherapy group in patients with intermediate-stage HCC.
See this image and copyright information in PMC

References

    1. Rumgay H., Arnold M., Ferlay J., Lesi O., Cabasag C.J., Vignat J., Laversanne M., McGlynn K.A., Soerjomataram I. Global Burden of Primary Liver Cancer in 2020 and Predictions to 2040. J. Hepatol. 2022;77:1598–1606. doi: 10.1016/j.jhep.2022.08.021. - DOI - PMC - PubMed
    1. Fu Z., Li X., Zhong J., Chen X., Cao K., Ding N., Liu L., Zhang X., Zhai J., Qu Z. Lenvatinib in Combination with Transarterial Chemoembolization for Treatment of Unresectable Hepatocellular Carcinoma (Uhcc): A Retrospective Controlled Study. Hepatol. Int. 2021;15:663–675. doi: 10.1007/s12072-021-10184-9. - DOI - PMC - PubMed
    1. Villanueva A. Hepatocellular Carcinoma. N. Engl. J. Med. 2019;380:1450–1462. doi: 10.1056/NEJMra1713263. - DOI - PubMed
    1. Llovet J.M., Villanueva A., Marrero J.A., Schwartz M., Meyer T., Galle P.R., Lencioni R., Greten T.F., Kudo M., Mandrekar S.J., et al. Trial Design and Endpoints in Hepatocellular Carcinoma: Aasld Consensus Conference. Hepatology. 2021;73((Suppl. S1)):158–191. doi: 10.1002/hep.31327. - DOI - PubMed
    1. Llovet J.M., Ricci S., Mazzaferro V., Hilgard P., Gane E., Blanc J.F., de Oliveira A.C., Santoro A., Raoul J.L., Forner A., et al. Sorafenib in Advanced Hepatocellular Carcinoma. N. Engl. J. Med. 2008;359:378–390. doi: 10.1056/NEJMoa0708857. - DOI - PubMed

LinkOut - more resources