Partial Splenic Embolization for Portal Hypertension Exacerbation During Atezolizumab/Bevacizumab Combination Therapy in Unresectable Hepatocellular Carcinoma.

IF 1.8 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

In vivo Pub Date : 2025-03-01 DOI:10.21873/invivo.13898

Toru Ishikawa, Nanako Terai, Ryo Sato, Hiroki Natsui, Takahiro Iwasawa, Masahiro Ogawa, Yuji Kobayashi, Toshifumi Sato, Junji Yokoyama, Akihiko Iiduka, Terasu Honma

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引用次数: 0

Abstract

Background/aim: The combination of atezolizumab and bevacizumab is the standard treatment for hepatocellular carcinoma (HCC). However, cases of portal hypertension (PHT) have been reported with atezolizumab/bevacizumab combination therapy. Splenomegaly caused by PHT may disrupt the immune environment and increase the risk of therapeutic failure with this combination therapy. Partial splenic embolization (PSE) is a treatment option for splenomegaly; however, the usefulness of PSE for PHT during atezolizumab/bevacizumab combination therapy is unclear. This study investigated the effect of PSE on the immune environment in a patient with splenomegaly caused by exacerbation of PHT during atezolizumab/bevacizumab combination therapy for HCC.

Patients and methods: Of the 56 patients with unresectable HCC treated with atezolizumab/bevacizumab, four with splenomegaly and progressive disease (PD) underwent PSE.

Results: PHT during atezolizumab/bevacizumab combination therapy led to a mean enlargement of the splenic size of 142.7%, an increase in the neutrophil-lymphocyte ratio (NLR), a decrease in lymphocyte counts, and a decrease in platelet counts. PSE increased platelet counts and lymphocyte counts, and decreased the NLR compared with pre-PSE levels. Atezolizumab/bevacizumab combination therapy, which caused PD due to PHT, resulted in a non-PD state with continued treatment after PSE.

Conclusion: In patients with PHT receiving atezolizumab/bevacizumab combination therapy, PSE promotes recovery from leukopenia and thrombocytopenia. Furthermore, PSE treatment may also induce host immune activation and boost immunity.

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来源期刊

In vivo 医学-医学：研究与实验

CiteScore

4.20

自引率

4.30%

发文量

330

审稿时长

3-8 weeks

期刊介绍： IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.