1. The safety and efficacy of first-line atezolizumab plus bevacizumab in patients with unresectable hepatocellular carcinoma: A multicenter real-world study from Turkey.
- Author
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Akyildiz A, Guven DC, Ozluk AA, Ismayilov R, Mutlu E, Unal OU, Yildiz I, Iriagac Y, Turhal S, Akbas S, Bayram E, Telli TA, Turkoz FP, Ozcelik M, Erciyestepe M, Selvi O, Gulbagci B, Erturk I, Isleyen ZS, Kahraman S, Akdag MO, Hamitoglu B, Unek IT, Unal C, Hacibekiroglu İ, Arslan C, Azizy A, Helvaci K, Demirci U, Dizdar O, Basaran M, Goker E, Sendur MA, and Yalcin S
- Subjects
- Aged, Female, Humans, Male, Bevacizumab therapeutic use, Retrospective Studies, Turkey epidemiology, Young Adult, Adult, Middle Aged, Aged, 80 and over, Carcinoma, Hepatocellular drug therapy, Liver Neoplasms drug therapy, Antineoplastic Combined Chemotherapy Protocols adverse effects
- Abstract
The aim of the study was to evaluate the real-world clinical outcomes of atezolizumab and bevacizumab (Atez/Bev) as the initial therapy for advanced hepatocellular carcinoma (HCC). We retrospectively analyzed 65 patients treated with Atez/Bev for advanced HCC from 22 institutions in Turkey between September 2020 and March 2023. Responses were evaluated by RECIST v1.1 criteria. The median progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan-Meier method. Cox regression model was employed to conduct multivariate analyses. The median age was 65 (range, 22-89) years, and 83.1% of the patients were male. A total of 1.5% achieved a complete response, 35.4% had a partial response, 36.9% had stable disease, and 26.2% had progressive disease. The disease control rate was 73.8% and associated with alpha-fetoprotein levels at diagnosis and concomitant antibiotic use. The incidence rates of any grade and grade ≥ 3 adverse events were 29.2% and 10.7%, respectively. At a median follow-up of 11.3 (3.4-33.3) months, the median PFS and OS were 5.1 (95% CI: 3-7.3) and 18.1 (95% CI: 6.2-29.9) months, respectively. In univariate analyses, ECOG-PS ≥ 1 (relative to 0), Child-Pugh class B (relative to A), neutrophil-to-lymphocyte ratio (NLR) > 2.9 (relative to ≤ 2.9), and concomitant antibiotic use significantly increased the overall risk of mortality. Multivariate analysis revealed that ECOG-PS ≥ 1 (HR: 2.69, P = .02), NLR > 2.9 (HR: 2.94, P = .017), and concomitant antibiotic use (HR: 4.18, P = .003) were independent predictors of OS. Atez/Bev is an effective and safe first-line therapy for advanced-stage HCC in a real-world setting. The survival benefit was especially promising in patients with a ECOG-PS score of 0, Child-Pugh class A, lower NLR, and patients who were not exposed to antibiotics during the treatment., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2023
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