Clinical Features and Outcomes of Conversion Therapy in Patients with Unresectable Hepatocellular Carcinoma.

Autor: Tomonari, Tetsu, Tani, Joji, Sato, Yasushi, Tanaka, Hironori, Tanaka, Takahiro, Taniguchi, Tatsuya, Kawano, Yutaka, Morishita, Asahiro, Okamoto, Koichi, Sogabe, Masahiro, Miyamoto, Hiroshi, Masaki, Tsutomu, Takayama, Tetsuji
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Zdroj: Cancers; Nov2023, Vol. 15 Issue 21, p5221, 13p
Abstrakt: Simple Summary: Conversion therapy has shown potential for improving the prognosis of patients with unresectable hepatocellular carcinoma (u-HCC). However, information on the characteristics and outcomes of patients undergoing conversion therapy is lacking. We examined 244 patients with u-HCC treated with lenvatinib (LEN) and atezolizumab + bevacizumab (Atezo + Bev). Of the 244 patients, 12 (4.9%) underwent conversion therapy, six out of 131 (4.6%) were treated with LEN, and six out of 113 (5.3%) were treated with Atezo + Bev. Eleven patients (91.7%) with a modified albumin bilirubin (mALBI) grade 1 or 2a and BCLC-B stage showed significantly higher rates of transition to conversion therapy (p < 0.05). Among the patients with u-HCC who were treated with LEN and Atezo + Bev, those with mALBI 1+2a and BCLC-B were likely to achieve conversion therapy with downstaging. The outcomes of the patients undergoing conversion therapy are promising. This retrospective multicenter study analyzed 244 patients with unresectable hepatocellular carcinoma treated with lenvatinib (LEN) and atezolizumab + bevacizumab (Atezo + Bev) to examine the characteristics, treatment courses, and prognoses. The cases of patients who could achieve HCC downstaging from Barcelona Clinic Liver Cancer (BCLC) stage B or C to A or zero indicated the need for conversion therapy. The patients' prognoses with and without conversion therapy were compared. Of the 244 patients, 12 (4.9%) underwent conversion therapy, six out of 131 (4.6%) were treated with LEN, and six out of 113 (5.3%) were treated with Atezo + Bev. Eleven patients (91.7%) with a modified albumin bilirubin (mALBI) grade 1 or 2a and BCLC-B stage showed significantly higher rates of transition during conversion therapy (p < 0.05). The patients undergoing conversion therapy had a significantly longer median overall survival rate than those receiving chemotherapy alone (1208 [1064–NA] vs. 569 [466–704] days, p < 0.01). A comparison of the patients who achieved a partial response with and without conversion was evaluated using propensity score matching to reduce the confounding factors, showing a significant survival benefit in the conversion group (1208 [1064–NA] vs. 665 days, p < 0.01). Among the patients with u-HCC who were treated with LEN and Atezo + Bev, those with mALBI 1 + 2a and BCLC-B were likely to achieve conversion therapy with downstaging. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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