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Relationship of atezolizumab plus bevacizumab treatment with muscle volume loss in unresectable hepatocellular carcinoma patients– multicenter analysis
Liver Cancer ( IF 13.8 ) Pub Date : 2022-12-08 , DOI: 10.1159/000527402
Atsushi Hiraoka 1 , Takashi Kumada 2 , Toshifumi Tada 3 , Masashi Hirooka 4 , Kazuya Kariyama 5 , Joji Tani 6 , Masanori Atsukawa 7 , Koichi Takaguchi 8 , Ei Itobayashi 9 , Shinya Fukunishi 10 , Kunihiko Tsuji 11 , Toru Ishikawa 12 , Kazuto Tajiri 13 , Hironori Ochi 14 , Satoshi Yasuda 15 , Hidenori Toyoda 15 , Chikara Ogawa 16 , Takashi Nishimura 17 , Takeshi Hatanaka 18 , Satoru Kakizaki 19 , Noritomo Shimada 20 , Kazuhito Kawata 21 , Atsushi Naganuma 22 , Masaki Kaibori 23 , Takaaki Tanaka 1 , Hideko Ohama 10 , Kazuhiro Nouso 5 , Asahiro Morishita 6 , Akemi Tsutsui 8 , Takuya Nagano 8 , Norio Itokawa 7 , Tomomi Okubo 7 , Taeang Arai 7 , Michitaka Imai 12 , Yohei Koizumi 4 , Shinichiro Nakamura 3 , Kouji Joko 14 , Hiroko Iijima 17 , Hisashi Kosaka 23 , Yoichi Hiasa 4 , Masatoshi Kudo 24
Affiliation  

Background/Aim: There is no known report regarding the relationship of atezolizumab plus bevacizumab (Atez/Bev) treatment with muscle volume loss (MVL) in unresectable hepatocellular carcinoma (u-HCC) patients. This study aimed to elucidate the clinical relationship between MVL and Atez/Bev. Materials/Methods: From September 2020 to December 2021, 229 u-HCC patients treated with Atez/Bev and with muscle volume data obtained by computed tomography at the baseline available were analyzed (median age, 74 years; males, 186 (81.2%); ECOG PS 0/1, 221 (96.5%); HCV:HBV:alcohol:others=81:33:40:75; Child-Pugh A, 212 (92.6%); mALBI grade 1:2a:2b=79:60:90; BCLC 0:A:B:C =1:24:87:117; median observation period, 6.8 months). Japan Society of Hepatology criteria were used for definition of MVL and prognostic factors were retrospectively evaluated. Results: Multivariate Cox-hazard analysis of prognostic factors for progression-free survival (PFS) showed elevated alpha-fetoprotein (AFP) (≥100 ng/mL) (HR 1.848, 95%CI 1.264-2.702, P=0.002), modified albumin-bilirubin (mALBI) grade (≥2a) (HR 1.563, 95%CI 1.035-2.359, P=0.034), and MVL (HR 1.479, 95%CI 1.020-2.144, P=0.039) as significant factors. For overall survival (OS), significant factors included elevated AFP (≥100 ng/mL) (HR 3.564, 95%CI 1.856-6.844, P<0.001), mALBI grade (≥2a) (HR 3.451, 95%CI 1.580-7.538, P=0.002), and MVL (HR 2.119, 95%CI 1.150-3.904, P=0.016). Patients with MVL (MVL group, n=91) showed worse PFS than those without (non-MVL group, n=138) (median PFS 5.3 vs. 7.6 months, P=0.025), while the MVL group showed worse OS (P=0.038), though neither reached the median survival time. Conclusion: MVL may be a clinical factor related to poor prognosis in patients receiving Atez/Bev treatment for u-HCC.


中文翻译:

阿特珠单抗联合贝伐珠单抗治疗与不可切除肝细胞癌患者肌肉体积损失的关系 – 多中心分析

背景/目的:目前尚无关于阿特珠单抗加贝伐单抗 (Atez/Bev) 治疗与不可切除肝细胞癌 (u-HCC) 患者肌肉体积损失 (MVL) 之间关系的已知报告。本研究旨在阐明 MVL 和 Atez/Bev 之间的临床关系。材料/方法:从 2020 年 9 月至 2021 年 12 月,分析了 229 名接受 Atez/Bev 治疗的 u-HCC 患者,并通过计算机断层扫描获得了可用基线的肌肉体积数据(中位年龄,74 岁;男性,186 名(81.2%) ;ECOG PS 0/1, 221 (96.5%);HCV:HBV:酒精:其他=81:33:40:75;Child-Pugh A,212 (92.6%);mALBI 等级 1:2a:2b=79: 60:90;BCLC 0:A:B:C =1:24:87:117;中位观察期,6.8 个月)。采用日本肝病学会标准定义 MVL 并回顾性评估预后因素。结果:无进展生存期 (PFS) 预后因素的多变量 Cox 风险分析显示甲胎蛋白 (AFP) 升高 (≥100 ng/mL)(HR 1.848,95% CI 1.264-2.702,P=0.002),经修改白蛋白-胆红素(mALBI)等级(≥2a)(HR 1.563,95%CI 1.035-2.359,P=0.034)和MVL(HR 1.479,95%CI 1.020-2.144,P=0.039)为重要因素。对于总生存期 (OS),显着因素包括 AFP 升高 (≥100 ng/mL) (HR 3.564,95%CI 1.856-6.844,P<0.001)、mALBI 分级 (≥2a) (HR 3.451,95%CI 1.580- 7.538,P=0.002),MVL(HR 2.119,95%CI 1.150-3.904,P=0.016)。患有 MVL 的患者(MVL 组,n=91)的 PFS 比没有 MVL 的患者(非 MVL 组,n=138)差(中位 PFS 5.3 个月 vs. 7.6 个月,P=0.025),而 MVL 组的 OS 较差(P =0.038),但均未达到中位生存时间。结论:MVL可能是接受Atez/Bev治疗的u-HCC患者预后不良的一个临床因素。
更新日期:2022-12-08
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