Feasibility of atezolizumab and bevacizumab combination regimens in patients with hepatocellular carcinoma and lung cancer taking direct oral anticoagulants

Autor: Tasuku Nakabori, Kei Kunimasa, Masaki Kawabata, Sena Higashi, Kaori Mukai, Takahisa Kawamura, Takako Inoue, Motohiro Tamiya, Kazumi Nishino, Kazuyoshi Ohkawa
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Cancer Medicine, Vol 13, Iss 12, Pp n/a-n/a (2024)
Druh dokumentu: article
ISSN: 2045-7634
DOI: 10.1002/cam4.7430
Popis: Abstract Aim Atezolizumab and bevacizumab (Atezo/Bev) combination immunotherapy regimens and direct oral anticoagulants (DOACs) are both associated with bleeding. Therefore, combining Atezo/Bev regimens with DOACs may exacerbate the bleeding risk. This study investigated the feasibility of the Atezo/Bev regimen in patients taking DOACs. Methods This retrospective study included 141 patients with unresectable hepatocellular carcinoma (HCC) or advanced lung cancer (LC) treated with Atezo/Bev regimens. Patients who used antithrombotic agents other than DOACs were excluded. Bleeding events during the Atezo/Bev regimen were analyzed. Results The incidence rates of bleeding of any grade in the DOAC (n = 11) and no antithrombotic agent (NAA) (n = 130) groups were 9.1% and 10.8%, respectively, with no significant differences. Moreover, no significant difference was found in the frequency of bleeding of grade ≥3 between the DOAC and NAA groups. No patients in the DOAC group discontinued the Atezo/Bev regimen because of severe bleeding. Although serum albumin levels, with a hazard ratio (HR) of 0.298 (95% confidence interval [CI]: 0.105–0.847), independently contributed to bleeding events (p = 0.023), DOAC administration did not (HR: 1.357; 95% CI: 0.157–10.54; p = 0.770). Among only patients with HCC (n = 59), none of the five patients taking DOACs experienced bleeding events. A high albumin–bilirubin score (HR: 9.083, 95% CI: 1.118–73.76) was associated with bleeding events (p = 0.039). Conclusions DOACs did not have a considerable effect on bleeding events in the Atezo/Bev regimens for HCC or LC. Under careful surveillance for bleeding, Atezo/Bev regimens may be feasible in patients receiving DOACs.
Databáze: Directory of Open Access Journals
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