阿替利珠单抗联合贝伐珠单抗治疗不可切除的晚期肝细胞癌的初步疗效及肝储备功能的重要性。

Initial therapeutic results of atezolizumab plus bevacizumab for unresectable advanced hepatocellular carcinoma and the importance of hepatic functional reserve.

机构信息

Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.

Department of Gastroenterology and Neurology, Kagawa University Graduate School of Medicine, Kagawa, Japan.

出版信息

Cancer Med. 2023 Feb;12(3):2646-2657. doi: 10.1002/cam4.5145. Epub 2022 Aug 14.

DOI:10.1002/cam4.5145

PMID:35964253

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9939118/

Abstract

AIM

We analyzed the association between the modified albumin-bilirubin (mALBI) grade and therapeutic efficacy of atezolizumab plus bevacizumab (Atezo+Bev) for the treatment of unresectable hepatocellular carcinoma (u-HCC).

METHODS

In this retrospective observational study, we included 71 u-HCC patients treated with Atezo+Bev between September 2020 and September 2021. Patients were grouped corresponding to the mALBI grade at the start of treatment (mALBI 1+2a or mALBI 2b+3) and analyzed for therapeutic effect and the transition rate to secondary treatment.

RESULTS

According to the Response Evaluation Criteria in Solid Tumors, the overall response rate was significantly higher for the mALBI 1+2a group, than for the mALBI 2b+3 group, with 26.2% and 3.4%, respectively. The progression-free survival (PFS) was significantly longer in the mALBI 1+2a group (10.5 months) than in the mALBI 2b+3 group (3.0 months). In the multivariate analysis, an mALBI of 1+2a was found to be an independent factor of PFS. The rate of second-line treatment with multi-targeted agents was also significantly higher in the mALBI 1+2a group.

CONCLUSIONS

In real-world practice, Atezo+Bev treatment might have higher therapeutic efficacy in u-HCC patients with mALBI 1+2a.

摘要

目的

我们分析了改良型Albumin-Bilirubin（mALBI）分级与阿替利珠单抗联合贝伐珠单抗（Atezo+Bev）治疗不可切除肝细胞癌（u-HCC）的疗效之间的关系。

方法

在这项回顾性观察性研究中，我们纳入了 2020 年 9 月至 2021 年 9 月期间接受 Atezo+Bev 治疗的 71 例 u-HCC 患者。根据治疗开始时的 mALBI 分级（mALBI 1+2a 或 mALBI 2b+3）将患者分组，并分析疗效和二线治疗的转化率。

结果

根据实体瘤反应评价标准，mALBI 1+2a 组的总缓解率明显高于 mALBI 2b+3 组，分别为 26.2%和 3.4%。mALBI 1+2a 组的无进展生存期（PFS）明显长于 mALBI 2b+3 组（10.5 个月比 3.0 个月）。多变量分析发现，mALBI 1+2a 是 PFS 的独立因素。mALBI 1+2a 组二线使用多靶点药物的比例也明显更高。