Impact of muscle volume changes following atezolizumab-bevacizumab therapy in patients with unresectable hepatocellular carcinoma

IF 3.4 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Hepatology Research Pub Date : 2025-05-07 DOI:10.1111/hepr.14201

Hironori Ochi, Joji Tani, Tetsu Tomonari, Hironori Tanaka, Yusuke Imai, Takaaki Tanaka, Hideko Ohama, Fujimasa Tada, Atsushi Hiraoka, Akira Hirose, Chikara Ogawa, Asahiro Morishita, Akio Moriya, Yoshiko Nakamura, Masashi Hirooka, Akihiro Deguchi, SYMPLE Study Group

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引用次数: 0

Abstract

Aim

This study aimed to evaluate the prognostic impact of muscle volume changes during atezolizumab-bevacizumab (AB) combination therapy (AB therapy) for unresectable hepatocellular carcinoma (u-HCC). Additionally, we evaluated whether changes in muscle volume relate to prognosis based on treatment response.

Methods

The present retrospective, multicenter study included 165 patients with u-HCC treated with AB therapy at eight institutions.

Results

The median albumin–bilirubin score in the entire cohort was −2.42. The objective response rate was 31.5%, and the disease control rate was 80.6%. The median overall survival (OS) was not reached, whereas the median progression-free survival (PFS) was 6.9 months (95% confidence interval [CI]: 5.3–8.5). At the first post-treatment computed tomography scan, patients were categorized into two groups: those with a nondecreased psoas muscle area index (PI) (group A) and those with a decreased PI (group B). The median OS was not reached in either group (p = 0.059). The median PFS was 10.5 months in group A and 5.5 months in group B (p = 0.025). Multivariate analysis using the Cox proportional hazards model identified alpha-fetoprotein ≥400 ng/mL (hazard ratio [HR]: 1.68; 95% CI: 1.11–2.54; p = 0.01) and decreased PI (HR: 1.59; 95% CI: 1.07–2.36; p = 0.02) as factors associated with PFS.

Conclusions

Nondecreased muscle volume after initiating AB therapy was associated with improved treatment efficacy and prognosis in patients with u-HCC.

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不可切除肝细胞癌患者阿特唑单抗-贝伐单抗治疗后肌肉体积变化的影响

目的：本研究旨在评估阿特唑单抗-贝伐单抗（AB）联合治疗（AB治疗）不可切除肝细胞癌（u-HCC）期间肌肉体积变化对预后的影响。此外，我们评估了基于治疗反应的肌肉体积变化是否与预后相关。方法：本回顾性多中心研究纳入了8家机构的165例接受AB治疗的u-HCC患者。结果：整个队列的中位白蛋白-胆红素评分为-2.42。客观有效率为31.5%，疾病控制率为80.6%。中位总生存期（OS）未达到，而中位无进展生存期（PFS）为6.9个月（95%置信区间[CI]: 5.3-8.5）。在治疗后的第一次计算机断层扫描中，将患者分为两组：腰肌面积指数（PI）未下降的患者（a组）和PI下降的患者（B组）。两组的中位OS均未达到（p = 0.059）。A组的中位PFS为10.5个月，B组为5.5个月（p = 0.025）。采用Cox比例风险模型进行多因素分析，发现甲胎蛋白≥400 ng/mL(风险比[HR]: 1.68；95% ci: 1.11-2.54；p = 0.01)， PI降低(HR: 1.59；95% ci: 1.07-2.36；p = 0.02)为PFS相关因素。结论：开始AB治疗后肌肉体积不减小与u-HCC患者治疗效果和预后改善有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hepatology Research 医学-胃肠肝病学

CiteScore

8.30

自引率

14.30%

发文量

124

审稿时长

1 months

期刊介绍： Hepatology Research (formerly International Hepatology Communications) is the official journal of the Japan Society of Hepatology, and publishes original articles, reviews and short comunications dealing with hepatology. Reviews or mini-reviews are especially welcomed from those areas within hepatology undergoing rapid changes. Short communications should contain concise definitive information.