Wang Jing-Houng, Chen Yen-Yang, Kee Kwong-Ming, Wang Chih-Chi, Tsai Ming-Chao, Kuo Yuan-Hung, Hung Chao-Hung, Li Wei-Feng, Lai Hsiang-Lan, Chen Yen-Hao
Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
Cancers (Basel). 2022 Jan 11;14(2):343. doi: 10.3390/cancers14020343.
Atezolizumab plus bevacizumab has been approved as the first-line systemic treatment for patients with unresectable hepatocellular carcinoma (uHCC). This study was designed to assess the clinical impact of atezolizumab plus bevacizumab in uHCC patients. A total of 48 uHCC patients receiving atezolizumab plus bevacizumab were identified, including first-line, second-line, third-line, and later-line settings. In these patients, the median progression-free survival (PFS) was 5.0 months, including 5.0 months for the first-line treatment, not reached for the second-line treatment, and 2.5 months for the third line and later line treatment. The objective response rate and disease control rate to atezolizumab plus bevacizumab were 27.1% and 68.8%, respectively. The severity of most adverse events was predominantly grade 1-2, and most patients tolerated the toxicities. The ratios of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) were used to predict PFS in these patients. The optimal cutoff values of NLR and PLR were 3 and 230, and NLR and PLR were independent prognostic factors for superior PFS in the univariate and multivariate analyses. Our study confirms the efficacy and safety of atezolizumab plus bevacizumab in uHCC patients in clinical practice and demonstrates the prognostic role of NLR and PLR for PFS in these patients.
阿替利珠单抗联合贝伐单抗已被批准作为不可切除肝细胞癌（uHCC）患者的一线全身治疗方案。本研究旨在评估阿替利珠单抗联合贝伐单抗对uHCC患者的临床影响。共纳入48例接受阿替利珠单抗联合贝伐单抗治疗的uHCC患者，包括一线、二线、三线及后续治疗阶段。在这些患者中，中位无进展生存期（PFS）为5.0个月，其中一线治疗为5.0个月，二线治疗未达到，三线及后续治疗为2.5个月。阿替利珠单抗联合贝伐单抗的客观缓解率和疾病控制率分别为27.1%和68.8%。大多数不良事件的严重程度主要为1 - 2级，大多数患者耐受这些毒性反应。中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）用于预测这些患者的PFS。NLR和PLR的最佳截断值分别为3和230，在单因素和多因素分析中，NLR和PLR是PFS延长的独立预后因素。我们的研究证实了阿替利珠单抗联合贝伐单抗在临床实践中对uHCC患者的疗效和安全性，并证明了NLR和PLR对这些患者PFS的预后作用。
