Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;
Department of Internal Medicine, Division of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Japan.
Anticancer Res. 2022 Mar;42(3):1403-1412. doi: 10.21873/anticanres.15610.
BACKGROUND/AIM: Atezolizumab plus bevacizumab therapy is the new standard treatment option for advanced hepatocellular carcinoma (HCC). The clinical details and sequential course after atezolizumab plus bevacizumab therapy remain to be determined.
Thirty-four consecutive patients who received atezolizumab plus bevacizumab therapy were evaluated. Their clinical outcomes were assessed according to liver function classified by modified albumin-bilirubin (ALBI) grade 1 and 2a (1/2a) versus 2b and treatment line (first-line versus second- or later-line). Furthermore, the treatment sequence after atezolizumab plus bevacizumab therapy was also assessed.
The objective response and disease control rates were 15.6% and 93.8%, respectively. The median proportions of ALBI scores at 1, 2, and 3 months relative to the baseline scores were 0.94, 0.97, and 0.93, respectively. The median proportions of α-fetoprotein (AFP) scores at 1, 2, and 3 months relative to the baseline scores were 0.98, 1.12, and 1.83, respectively. There were no significant differences in the changes in the proportions of AFP and ALBI scores according to both liver function and treatment line. Twelve patients were administered lenvatinib treatment after the failure of atezolizumab plus bevacizumab therapy. The proportions of AFP and ALBI scores at 1 month relative to the baseline scores were 0.55 and 0.81, respectively.
Atezolizumab plus bevacizumab therapy can be effective for advanced HCC irrespective of the patients' liver function and treatment line. Lenvatinib administration after atezolizumab plus bevacizumab therapy can be effective, although special attention should be paid to the deterioration of liver function.
背景/目的：阿替利珠单抗联合贝伐珠单抗治疗是晚期肝细胞癌（HCC）的新标准治疗选择。阿替利珠单抗联合贝伐珠单抗治疗后的临床细节和序贯过程仍有待确定。
对 34 例接受阿替利珠单抗联合贝伐珠单抗治疗的患者进行了评估。根据改良白蛋白-胆红素（ALBI）分级 1 和 2a（1/2a）与 2b 和治疗线（一线与二线或以后线）评估其临床结局。此外，还评估了阿替利珠单抗联合贝伐珠单抗治疗后的治疗顺序。
客观缓解率和疾病控制率分别为 15.6%和 93.8%。与基线评分相比，1、2 和 3 个月时 ALBI 评分的中位数比例分别为 0.94、0.97 和 0.93。与基线评分相比，1、2 和 3 个月时 AFP 评分的中位数比例分别为 0.98、1.12 和 1.83。根据肝功能和治疗线，AFP 和 ALBI 评分比例的变化没有显著差异。12 例患者在阿替利珠单抗联合贝伐珠单抗治疗失败后接受了仑伐替尼治疗。与基线评分相比，1 个月时 AFP 和 ALBI 评分的中位数比例分别为 0.55 和 0.81。
阿替利珠单抗联合贝伐珠单抗治疗对晚期 HCC 有效，无论患者的肝功能和治疗线如何。阿替利珠单抗联合贝伐珠单抗治疗后给予仑伐替尼治疗可能有效，尽管应特别注意肝功能恶化。
