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阿替利珠单抗联合贝伐单抗治疗肝细胞癌患者的不良事件与预后的关联:一项多中心回顾性研究

Association between Adverse Events and Prognosis in Patients with Hepatocellular Carcinoma Treated with Atezolizumab Plus Bevacizumab: A Multicenter Retrospective Study.

作者信息

Shimose Shigeo, Iwamoto Hideki, Tanaka Masatoshi, Niizeki Takashi, Kajiwara Masahiko, Itano Satoshi, Moriyama Etsuko, Shirono Tomotake, Noda Yu, Kamachi Naoki, Nakano Masahito, Kuromatsu Ryoko, Koga Hironori, Kawaguchi Takumi

机构信息

Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan.

Iwamoto Internal Medical Clinic, Kitakyusyu 802-0832, Japan.

出版信息

Cancers (Basel). 2022 Sep 1;14(17):4284. doi: 10.3390/cancers14174284.

Abstract

This study aimed to evaluate the correlation between adverse events (AEs) and overall survival (OS) in patients with unresectable hepatocellular carcinoma treated with atezolizumab plus bevacizumab (atezo/beva). This was a multicenter study in which 130 patients were enrolled. Hypertension and skin disorders had a significant correlation with longer survival (median survival time (MST): not reached vs. 14.3 months and not reached vs. 14.8 months, = 0.001 and = 0.047, respectively). In contrast, liver injuries were significantly correlated with shorter survival (MST: 14.7 months vs. not reached, = 0.036), and the median development time was 21 days. In a logistic regression analysis, fatigue ≥ grade 2, liver injury ≥ grade 3, and modified albumin-bilirubin grade 2b were identified as independent factors for discontinuation due to AEs. The OS in the no discontinuation due to AE group was significantly longer than that in the discontinuation due to AEs group (MST not reached vs. 11.2 months, = 0.001). We concluded that the development of liver injury was a negative factor for OS and that we should be vigilant in monitoring AE during atezo/beva treatments.

摘要

本研究旨在评估接受阿替利珠单抗联合贝伐珠单抗(阿替利珠单抗/贝伐珠单抗)治疗的不可切除肝细胞癌患者中不良事件(AE)与总生存期(OS)之间的相关性。这是一项多中心研究,共纳入130例患者。高血压和皮肤疾病与更长的生存期显著相关(中位生存期(MST):未达到 vs. 14.3个月以及未达到 vs. 14.8个月,P分别为0.001和0.047)。相比之下,肝损伤与较短的生存期显著相关(MST:14.7个月 vs. 未达到,P = 0.036),且中位发生时间为21天。在逻辑回归分析中,疲劳≥2级、肝损伤≥3级以及改良白蛋白-胆红素分级2b被确定为因AE导致停药的独立因素。未因AE停药组的OS显著长于因AE停药组(MST未达到 vs. 11.2个月,P = 0.001)。我们得出结论,肝损伤的发生是OS的负面因素,并且在阿替利珠单抗/贝伐珠单抗治疗期间我们应警惕监测AE。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0db9/9454839/7d4a6b0fa35e/cancers-14-04284-g001.jpg

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