Comparison of Efficacy and Safety of Atezolizumab Plus Bevacizumab and Lenvatinib as First-Line Therapy for Unresectable Hepatocellular Carcinoma: A Propensity Score Matching Analysis.

Autor: Niizeki T; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan., Tokunaga T; Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan., Takami Y; Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan., Wada Y; Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan., Harada M; Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan., Shibata M; Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan., Nakao K; Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan., Sasaki R; Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan., Hirai F; Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan., Shakado S; Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan., Yoshizumi T; Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Itoh S; Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Yatsuhashi H; Clinical Research Center, Department of Hepatology, National Hospital Organization Nagasaki Medical Center, Nagasaki University Graduate School of Biomedical Sciences, Omura, Nagasaki, Japan., Bekki S; Clinical Research Center, Department of Hepatology, National Hospital Organization Nagasaki Medical Center, Nagasaki University Graduate School of Biomedical Sciences, Omura, Nagasaki, Japan., Ido A; Department of Human and Environmental Sciences, Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan., Mawatari S; Department of Human and Environmental Sciences, Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan., Honda K; Department of Gastroenterology, Faculty of Medicine, Oita University, Yufu, Japan., Sugimoto R; Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan., Senju T; Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan., Takahashi H; Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan., Kuwashiro T; Liver Center, Faculty of Medicine, Saga University Hospital, Saga University, Saga, Japan., Maeshiro T; First Department of Internal Medicine, University of the Ryukyus Hospital, Okinawa, Japan., Nakamuta M; Department of Gastroenterology and Hepatology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan., Aratake Y; Department of Gastroenterology and Hepatology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan., Yamashita T; Department of Gastroenterology, National Hospital Organization Oita Medical Center, Oita, Japan., Otsuka Y; Department of Gastroenterology, National Hospital Organization Oita Medical Center, Oita, Japan., Matsumoto S; Department of Gastroenterology, Fukuoka Tokushukai Hospital, Kasuga, Japan., Sohda T; Department of Hepatology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan., Shimose S; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan. shimose_shigeo@med.kurume-u.ac.jp., Murotani K; Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume, Fukuoka, Japan., Tanaka Y; Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Jazyk: angličtina
Zdroj: Targeted oncology [Target Oncol] 2022 Nov; Vol. 17 (6), pp. 643-653. Date of Electronic Publication: 2022 Oct 22.
DOI: 10.1007/s11523-022-00921-x
Abstrakt: Background: A comparison between atezolizumab plus bevacizumab (ATEZO/BEVA) and lenvatinib (LEN) for the treatment of hepatocellular carcinoma (HCC) remains unclear.
Objective: This study aimed to compare the therapeutic effects and safety of ATEZO/BEVA and LEN as first-line therapies for HCC.
Patients and Methods: This study was a retrospective analysis of 810 patients with HCC who underwent ATEZO/BEVA (n = 186) or LEN (n = 624) as first-line systemic therapy between March 2018 to March 2022 at 14 facilities. After propensity score matching, 304 patients (ATEZO/BEVA group: n = 152; LEN group: n = 152) were analyzed.
Results: After propensity score matching, although there was no significant difference in objective response rates (ORRs) between the ATEZO/BEVA and LEN groups (ORR 44.8% vs. 46.7%, p = 0.644), the median progression-free survival (PFS) and median overall survival (OS) in the ATEZO/BEVA group were significantly higher than those in the LEN group (median PFS: 8.3 months vs. 6.0 months, p = 0.005; median OS: not reached vs. 20.2 months, p = 0.039). The rates of appetite loss, fatigue, and proteinuria of grade 3 or higher in the ATEZO/BEVA group were lower than those in the LEN group. However, the rate of bleeding of grade 3 or higher in the ATEZO/BEVA group was higher than that in the LEN group. The conversion rate was higher in the ATEZO/BEVA group than that in the LEN group (8.6% vs. 1.9%, p = 0.007).
Conclusions: ATEZO/BEVA showed superiority to LEN in terms of prognosis and conversion rate as first-line therapy. Moreover, ATEZO/BEVA had a lower rate of severe adverse events, except for bleeding, than LEN.
(© 2022. The Author(s).)
Databáze: MEDLINE
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