Comparing the impact of atezolizumab plus bevacizumab and lenvatinib on the liver function in hepatocellular carcinoma patients: A mixed-effects regression model approach.

Autor: Hatanaka T; Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan., Kakizaki S; Department of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.; Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan., Hiraoka A; Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan., Tada T; Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan., Hirooka M; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan., Kariyama K; Department of Gastroenterology, Okayama City Hospital, Okayama, Japan., Tani J; Department of Gastroenterology and Neurology, Kagawa University, Kita-gun, Japan., Atsukawa M; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan., Takaguchi K; Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan., Itobayashi E; Department of Gastroenterology, Asahi General Hospital, Asahi, Japan., Fukunishi S; Department of Gastroenterology, Division of Hepatobiliary and Pancreatic Diseases, Hyogo Medical University, Nishinomiya, Japan., Tsuji K; Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan., Ishikawa T; Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan., Tajiri K; Department of Gastroenterology, Toyama University Hospital, Toyama, Japan., Ochi H; Center for Liver-Biliary-Pancreatic Disease, Matsuyama Red Cross Hospital, Matsuyama, Japan., Yasuda S; Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Japan., Toyoda H; Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Japan., Ogawa C; Department of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Japan., Yokohama K; Department of Gastroenterology, Osaka Medical and Pharmaceutical University, Osaka, Japan., Nishikawa H; Department of Gastroenterology, Osaka Medical and Pharmaceutical University, Osaka, Japan., Nishimura T; Department of Gastroenterology, Division of Hepatobiliary and Pancreatic Diseases, Hyogo Medical University, Nishinomiya, Japan., Shimada N; Division of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Japan., Kawata K; Hepatology Division, Department of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan., Kosaka H; Department of Surgery, Kansai Medical University, Hirakata, Japan., Naganuma A; Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan., Yata Y; Department of Gastroenterology, Hanwa Memorial Hospital, Osaka, Japan., Ohama H; Department of Gastroenterology, Takarazuka City Hospital, Takarazuka, Japan., Kuroda H; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan., Tanaka K; Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan., Tanaka T; Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan., Tada F; Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan., Nouso K; Department of Gastroenterology, Okayama City Hospital, Okayama, Japan., Morishita A; Department of Gastroenterology and Neurology, Kagawa University, Kita-gun, Japan., Tsutsui A; Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan., Nagano T; Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan., Itokawa N; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan., Okubo T; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan., Arai T; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan., Imai M; Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan., Koizumi Y; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan., Nakamura S; Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan., Kaibori M; Department of Surgery, Kansai Medical University, Hirakata, Japan., Iijima H; Department of Gastroenterology, Division of Hepatobiliary and Pancreatic Diseases, Hyogo Medical University, Nishinomiya, Japan., Hiasa Y; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan., Kudo M; Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan., Kumada T; Department of Nursing, Gifu Kyoritsu University, Ogaki, Japan.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2023 Dec; Vol. 12 (24), pp. 21680-21693. Date of Electronic Publication: 2023 Nov 21.
DOI: 10.1002/cam4.6726
Abstrakt: Aim: This retrospective study compared the impact of atezolizumab plus bevacizumab (Atez/Bev) and lenvatinib (LEN) on the liver function in patients with hepatocellular carcinoma.
Methods: We included 526 patients who received Atez/Bev and 731 who received LEN March 2018 and July 2022 in this study. We conducted a 1:1 propensity-score-matched analysis and identified 324 patients in each group for inclusion in the present analysis. Nonlinear mixed-effects regression models were employed, allowing for the evaluation and inclusion of cases where treatment was interrupted due to disease progression, adverse events, or loss to follow-up. These models were used to compare the ALBI score between the Atez/Bev and LEN groups.
Results: Following propensity score matching, the mean ALBI scores in the Atez/Bev and LEN groups were -2.41 ± 0.40 and -2.44 ± 0.42 at baseline, and -2.17 ± 0.56 and -2.19 ± 0.58 at 12 weeks, respectively. Although the ALBI score significantly worsened during treatment in both groups (p < 0.001), there was no significant difference in the rate of ALBI score deterioration between the groups (p = 0.06). Subgroup analyses showed that LEN-treated patients with BCLC advanced stage (p = 0.02) and those who initially received the full dose (p < 0.001) had a significantly greater worsening of ALBI score compared to Atez/Bev.
Conclusions: Using a nonlinear mixed-effects regression approach, which allowed for the inclusion of cases with treatment interruption, we found no significant difference in the trend of liver function deterioration between the Atez/Bev and LEN groups. Caution should be exercised for LEN-treated patients with BCLC advanced stage or those receiving the full dose of LEN.
(© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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