Tiago de Castro, Sabrina Welland, Leonie Jochheim, Cathrine Leyh, Kateryna Shmanko, Fabian Finkelmeier, Petia Jeliazkova, Andre Jefremow, Maria A Gonzalez-Carmona, Arne Kandulski, Daniel Roessler, Najib Ben Khaled, Stefan Enssle, Marino Venerito, Thorben W Fründt, Michael Schultheiß, Angela Djanani, Maria Pangerl, Andreas Maieron, Thomas C Wirth, Jens U Marquardt, Richard Greil, Christina Fricke, Rainer Günther, Andreas Schmiderer, Dominik Bettinger, Henning Wege, Bernhard Scheiner, Martina Müller, Christian P Strassburg, Jürgen Siebler, Ursula Ehmer, Oliver Waidmann, Arndt Weinmann, Matthias Pinter, Christian M Lange, Anna Saborowski, Arndt Vogel
{"title":"Atezolizumab/bevacizumab and lenvatinib for hepatocellular carcinoma: A comparative analysis in a European real-world cohort.","authors":"Tiago de Castro, Sabrina Welland, Leonie Jochheim, Cathrine Leyh, Kateryna Shmanko, Fabian Finkelmeier, Petia Jeliazkova, Andre Jefremow, Maria A Gonzalez-Carmona, Arne Kandulski, Daniel Roessler, Najib Ben Khaled, Stefan Enssle, Marino Venerito, Thorben W Fründt, Michael Schultheiß, Angela Djanani, Maria Pangerl, Andreas Maieron, Thomas C Wirth, Jens U Marquardt, Richard Greil, Christina Fricke, Rainer Günther, Andreas Schmiderer, Dominik Bettinger, Henning Wege, Bernhard Scheiner, Martina Müller, Christian P Strassburg, Jürgen Siebler, Ursula Ehmer, Oliver Waidmann, Arndt Weinmann, Matthias Pinter, Christian M Lange, Anna Saborowski, Arndt Vogel","doi":"10.1097/HC9.0000000000000562","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Immunotherapy-based combinations are currently the standard of care in the systemic treatment of patients with HCC. Recent studies have reported unexpectedly long survival with lenvatinib (LEN), supporting its use in first-line treatment for HCC. This study aims to compare the real-world effectiveness of LEN to atezolizumab/bevacizumab (AZ/BV).</p><p><strong>Methods: </strong>A retrospective analysis was conducted to evaluate the effectiveness and safety of frontline AZ/BV or LEN therapy in patients with advanced HCC across 18 university hospitals in Europe.</p><p><strong>Results: </strong>The study included 412 patients (AZ/BV: n=207; LEN: n=205). Baseline characteristics were comparable between the 2 treatment groups. However, patients treated with AZ/BV had a significantly longer median progression-free survival compared to those receiving LEN. The risk of hepatic decompensation was significantly higher in patients with impaired baseline liver function (albumin-bilirubin [ALBI] grade 2) treated with AZ/BV compared to those with preserved liver function. Patients with alcohol-associated liver disease had poorer baseline liver function compared to other etiologies and exhibited a worse outcome under AZ/BV.</p><p><strong>Conclusions: </strong>In this real-world cohort, survival rates were similar between patients treated with LEN and those treated with AZ/BV, confirming that both are viable first-line options for HCC. The increased risk of hepatic decompensation in patients treated with AZ/BV who have impaired baseline liver function underscores the need for careful monitoring. Future trials should aim to distinguish more clearly between metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"8 11","pages":""},"PeriodicalIF":5.6000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537570/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hepatology Communications","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/HC9.0000000000000562","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Immunotherapy-based combinations are currently the standard of care in the systemic treatment of patients with HCC. Recent studies have reported unexpectedly long survival with lenvatinib (LEN), supporting its use in first-line treatment for HCC. This study aims to compare the real-world effectiveness of LEN to atezolizumab/bevacizumab (AZ/BV).
Methods: A retrospective analysis was conducted to evaluate the effectiveness and safety of frontline AZ/BV or LEN therapy in patients with advanced HCC across 18 university hospitals in Europe.
Results: The study included 412 patients (AZ/BV: n=207; LEN: n=205). Baseline characteristics were comparable between the 2 treatment groups. However, patients treated with AZ/BV had a significantly longer median progression-free survival compared to those receiving LEN. The risk of hepatic decompensation was significantly higher in patients with impaired baseline liver function (albumin-bilirubin [ALBI] grade 2) treated with AZ/BV compared to those with preserved liver function. Patients with alcohol-associated liver disease had poorer baseline liver function compared to other etiologies and exhibited a worse outcome under AZ/BV.
Conclusions: In this real-world cohort, survival rates were similar between patients treated with LEN and those treated with AZ/BV, confirming that both are viable first-line options for HCC. The increased risk of hepatic decompensation in patients treated with AZ/BV who have impaired baseline liver function underscores the need for careful monitoring. Future trials should aim to distinguish more clearly between metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease.
期刊介绍:
Hepatology Communications is a peer-reviewed, online-only, open access journal for fast dissemination of high quality basic, translational, and clinical research in hepatology. Hepatology Communications maintains high standard and rigorous peer review. Because of its open access nature, authors retain the copyright to their works, all articles are immediately available and free to read and share, and it is fully compliant with funder and institutional mandates. The journal is committed to fast publication and author satisfaction.