Abramson Cancer Center, University of Pennsylvania, 12 Perelman Ctr South Pavilion, 3400 Civic Center Blvd, Philadelphia, PA, 19104-4283, USA.
Penn Center for Cancer Care Innovation, University of Pennsylvania, Philadelphia, PA, USA.
J Cancer Res Clin Oncol. 2023 Jun;149(6):2345-2354. doi: 10.1007/s00432-023-04590-9. Epub 2023 Mar 2.
Hepatocellular carcinoma (HCC) is a common and deadly form of liver cancer. Combination atezolizumab and bevacizumab has improved the outcomes for patients with advanced disease. We sought to determine the impact of etiology on outcomes of patients treated with atezolizumab and bevacizumab.
This study used a real-world database. The primary outcome was overall survival (OS) by etiology of HCC; the secondary outcome was real-world time to treatment discontinuation (rwTTD). Time-to-event analyses was performed by the Kaplan-Meier method; the log-rank test to assess for differences by etiology from date of first receipt of atezolizumab and bevacizumab. The Cox proportional hazards model was used to calculate hazard ratios.
In total, 429 patients were included (n = 216 Viral-HCC; n = 68 Alcohol-HCC; n = 145, NASH-HCC). The median overall survival for the entire cohort was 9.4 months (95% CI 7.1-10.9). Compared with Viral-HCC, the hazard ratio (HR) of death was 1.11 (95% CI 0.74-1.68, p = 0.62) for Alcohol-HCC and was 1.34 (95% CI 0.96-1.86, p = 0.08) for NASH-HCC. The median rwTTD for the entire cohort was 5.7 months (95% CI 5.0-7.0 months). The HR of rwTTD was 1.24 (95% CI 0.86-1.77, p = 0.25) for Alcohol-HCC and was 1.31 (95% CI 0.98-1.75, p = 0.06) in reference to TTD with Viral-HCC.
In this real-world cohort of patients with HCC receiving first-line atezolizumab and bevacizumab, we did not identify an association between etiology and OS or rwTTD. This suggests that the efficacy of atezolizumab and bevacizumab may be similar across HCC etiologies. Further prospective studies are needed to confirm these findings.
肝细胞癌（HCC）是一种常见且致命的肝癌形式。阿替利珠单抗联合贝伐珠单抗已改善了晚期疾病患者的预后。我们旨在确定病因对接受阿替利珠单抗和贝伐珠单抗治疗的患者结局的影响。
本研究使用了真实世界数据库。主要结局是由 HCC 的病因决定的总生存期（OS）；次要结局是真实世界的治疗停药时间（rwTTD）。通过 Kaplan-Meier 法进行时间事件分析；通过对数秩检验评估从首次接受阿替利珠单抗和贝伐珠单抗之日起病因之间的差异。使用 Cox 比例风险模型计算风险比。
共纳入 429 例患者（n=216 例病毒性 HCC；n=68 例酒精性 HCC；n=145 例 NASH-HCC）。整个队列的中位总生存期为 9.4 个月（95%CI 7.1-10.9）。与病毒性 HCC 相比，酒精性 HCC 的死亡风险比（HR）为 1.11（95%CI 0.74-1.68，p=0.62），NASH-HCC 的 HR 为 1.34（95%CI 0.96-1.86，p=0.08）。整个队列的中位 rwTTD 为 5.7 个月（95%CI 5.0-7.0 个月）。rwTTD 的 HR 为 1.24（95%CI 0.86-1.77，p=0.25），与病毒性 HCC 相比，酒精性 HCC 的 rwTTD 为 1.31（95%CI 0.98-1.75，p=0.06）。
在接受阿替利珠单抗和贝伐珠单抗一线治疗的 HCC 患者的真实世界队列中，我们未发现病因与 OS 或 rwTTD 之间存在关联。这表明阿替利珠单抗和贝伐珠单抗的疗效可能在不同的 HCC 病因之间相似。需要进一步的前瞻性研究来证实这些发现。
