Efficacy of locoregional treatment for oligo-drug-resistant lesions during first-line atezolizumab plus bevacizumab therapy for unresectable hepatocellular carcinoma: a single-center retrospective study.
Tasuku Nakabori, Sena Higashi, Kaori Mukai, Toshiki Ikawa, Noboru Maeda, Masaki Kawabata, Kana Hosokawa, Kazuhiro Kozumi, Makiko Urabe, Yugo Kai, Ryoji Takada, Kenji Ikezawa, Koji Konishi, Katsuyuki Nakanishi, Kazuyoshi Ohkawa
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引用次数: 0
Abstract
Introduction: Despite recent advancements, outcomes for unresectable hepatocellular carcinoma (HCC) treated with atezolizumab plus bevacizumab (atezo/bev) remain suboptimal, with drug resistance posing a major challenge. This study evaluated the efficacy of additional locoregional treatments (LRTs) for oligo-atezo/bev-resistant lesions.
Methods: We retrospectively analyzed patients with intermediate-stage and advanced-stage HCC who developed drug-resistant lesions during first-line atezo/bev therapy. Patients were divided into two groups: the combination therapy group (n=10) receiving additional LRT and the atezo/bev alone group (n=26). Progression-free survival (PFS) 1 was measured from atezo/bev therapy initiation to progressive disease (PD) or death, whereas PFS2 was calculated from atezo/bev therapy initiation to PD of second-line therapy or death. The PFS1 in the combination therapy group was compared to the PFS1 and PFS2 in the atezo/bev alone group. Two analyses were performed for the PFS and overall survival (OS): one including the total cohort and the other restricted to those eligible for LRT upon the appearance of atezo/bev-resistant lesions. Changes in the hepatic reserve before and after LRT were also assessed.
Results: LRT, followed by continued atezo/bev therapy, safely eradicated drug-resistant lesions in the combination therapy group, without compromising the hepatic reserve. All patients in the combination therapy group transitioned to second-line treatment due to preserved hepatic reserve after PD. The PFS1 in the combination therapy group was longer than the PFS1 and PFS2 in the atezo/bev alone group in both the total cohort and LRT-eligible subgroup. Similarly, the OS in the combination therapy group was longer than in the atezo/bev alone group in both analyses.
Conclusion: LRTs may provide a viable option for managing oligo-drug-resistant lesions during first-line atezo/bev therapy for unresectable HCC when safely administered.
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Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.
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