1. Outcomes of Patients with Child-Pugh B and Unresectable Hepatocellular Carcinoma Undergoing First-Line Systemic Treatment with Sorafenib, Lenvatinib, or Atezolizumab Plus Bevacizumab.
- Author
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Kikugawa, Chihiro, Uchikawa, Shinsuke, Kawaoka, Tomokazu, Kinami, Takahiro, Yano, Shigeki, Amioka, Kei, Naruto, Kensuke, Ando, Yuwa, Yamaoka, Kenji, Tsuge, Masataka, Kosaka, Yumi, Ohya, Kazuki, Mori, Nami, Takaki, Shintaro, Tsuji, Keiji, Kouno, Hirotaka, Kohno, Hiroshi, Morio, Kei, Moriya, Takashi, and Nonaka, Michihiro
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LIVER physiology , *THERAPEUTIC use of antineoplastic agents , *COMBINATION drug therapy , *PEARSON correlation (Statistics) , *STATISTICAL significance , *BEVACIZUMAB , *FISHER exact test , *LOGISTIC regression analysis , *SORAFENIB , *TREATMENT effectiveness , *RETROSPECTIVE studies , *MANN Whitney U Test , *CHI-squared test , *MULTIVARIATE analysis , *DESCRIPTIVE statistics , *IMMUNE checkpoint inhibitors , *LONGITUDINAL method , *KAPLAN-Meier estimator , *LOG-rank test , *LUNG tumors , *STATISTICS , *CANCER patient psychology , *PROGRESSION-free survival , *DATA analysis software , *HEPATOCELLULAR carcinoma , *LIVER function tests , *OVERALL survival , *PROPORTIONAL hazards models - Abstract
Introduction: Systemic therapy is recommended for patients with Child-Pugh A in hepatocellular carcinoma (HCC). We analyzed the outcomes of a cohort of patients with HCC who received either sorafenib (Sor), lenvatinib (Len) or atezolizumab plus bevacizumab (Atezo + Bev) as first-line systemic therapy for HCC, with the aim of identifying prognostic factors for survival. Methods: A total of 825 patients with advanced HCC and Child-Pugh A or B received either Sor, Len or Atezo + Bev as first-line systemic therapy. Liver function was assessed according to the Child-Pugh score and the modified albumin-bilirubin (mALBI) grade. Results: Prognosis was analyzed according to liver function such as Child-Pugh classifications, scores, and mALBI grades that worsened with a decline in liver function (p <0.001 for all). A Child-Pugh score of 7 was a factor significantly associated with OS. In patients with a Child-Pugh score of 7, an mALBI grade of 3 was an independent predictor of OS. In Child-Pugh B patients with HCC, receiving Atezo + Bev was identified as a factor associated with PFS. Conclusion: Determining the hepatic reserve of patients with unresectable HCC might be useful for identifying patents suitable for systemic treatment for HCC. Atezo + Bev might prolong the PFS of patients with a Child-Pugh score of 7. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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