Efficacy and safety of atezolizumab and bevacizumab with or without TACE as first-line therapy for unresectable HCC: a multicenter cohort study.

IF 6.1 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Hepatology International Pub Date : 2025-08-25 DOI:10.1007/s12072-025-10895-3

Ningning Zhang, Kaipeng Liu, Yuexi Yu, Kai Yuan, Haipeng Yu, Jean Charles Nault, Claudia Campani, Lorraine Blaise, Sara Mouri, Eleonore Spitzer, Yawei Du, Shuwen Zhang, Wenwen Zhu, Hao Yu, Tian Liu, Xuanchen Liu, Ming Luo, Huiru Liu, Yiyan Zhang, Yiming Huo, Feng Duan, Manon Allaire, Wei Lu, Jihui Hao

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引用次数: 0

Abstract

Background and aims: Transarterial chemoembolization (TACE) combined with immunotherapy and targeted therapy provides a promising therapy for unresectable hepatocellular carcinoma (HCC). This study aimed to compare the efficacy and safety of TACE combined with atezolizumab and bevacizumab (TACE-Ate-Bev) or atezolizumab and bevacizumab alone (Ate-Bev) as first-line treatment for unresectable HCC.

Methods: This multicenter cohort study recruited patients with unresectable HCC who received TACE-Ate-Bev or Ate-Bev as first-line treatment between July 1, 2020 and December 31, 2023. Inverse probability of treatment weighting (IPTW) was employed to minimize bias. Overall survival (OS), progression-free survival (PFS), and adverse events (AEs) were observed.

Results: 311 patients were included in this analysis, with 152 in the TACE-Ate-Bev group and 159 in the Ate-Bev group. The TACE-Ate-Bev group demonstrated significantly improved OS (26.8 [95% CI 23.1-NR] vs. 14.9 [95% CI 11.4-19.9] months, p < 0.0001) and PFS (16.0 [95% CI 12.8-17.8] vs. 6.5 [95% CI 5.4-7.6] months, p < 0.0001) compared to the Ate-Bev group, both in BCLC stage B (mOS: NR vs. 15.6 months, p < 0.0001; mPFS: 16.9 vs. 6.7 months, p < 0.0001) and BCLC stage C (mOS: 25.2 vs. 14.3 months, p = 0.00018; mPFS: 12.8 vs. 6.5 months, p < 0.0001) disease. After IPTW adjustment, the TACE-Ate-Bev group also demonstrated significantly improved OS and PFS compared to the Ate-Bev group, both in BCLC stage B and BCLC stage C disease. Grade 3-4 AEs were observed in 36 patients (24.3%) in the TACE-Ate-Bev group and 34 (21.4%) in the Ate-Bev group. There was no statistically significant difference in the proportion of gastrointestinal bleeding between the TACE-Ate-Bev and Ate-Bev groups (9.9 vs. 10.1%, p = 0.954).

Conclusion: TACE-Ate-Bev significantly improves OS and PFS with acceptable toxicity compared with Ate-Bev as first-line therapy for unresectable HCC.

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阿特唑单抗和贝伐单抗联合或不联合TACE作为一线治疗不可切除HCC的疗效和安全性：一项多中心队列研究

背景与目的：经动脉化疗栓塞（TACE）联合免疫治疗和靶向治疗为不可切除的肝细胞癌（HCC）提供了一种很有前景的治疗方法。本研究旨在比较TACE联合atezolizumab和贝伐单抗（TACE-Ate-Bev）或atezolizumab和贝伐单抗单独（Ate-Bev）作为一线治疗不可切除HCC的疗效和安全性。方法：这项多中心队列研究招募了2020年7月1日至2023年12月31日期间接受TACE-Ate-Bev或Ate-Bev作为一线治疗的不可切除HCC患者。采用处理加权逆概率（IPTW）最小化偏倚。观察总生存期（OS）、无进展生存期（PFS）和不良事件（ae）。结果：311例患者纳入分析，其中TACE-Ate-Bev组152例，Ate-Bev组159例。结论：作为不可切除HCC的一线治疗，与Ate-Bev相比，TACE-Ate-Bev可显著改善OS和PFS (26.8 [95% CI 23.1-NR] vs. 14.9 [95% CI 11.4-19.9]个月。

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 International 医学-胃肠肝病学

CiteScore

10.90

自引率

3.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： Hepatology International is the official journal of the Asian Pacific Association for the Study of the Liver (APASL). This is a peer-reviewed journal featuring articles written by clinicians, clinical researchers and basic scientists is dedicated to research and patient care issues in hepatology. This journal will focus mainly on new and emerging technologies, cutting-edge science and advances in liver and biliary disorders. Types of articles published: -Original Research Articles related to clinical care and basic research -Review Articles -Consensus guidelines for diagnosis and treatment -Clinical cases, images -Selected Author Summaries -Video Submissions