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Current Perspectives on Perioperative Combination Therapy for Hepatocellular Carcinoma. 肝细胞癌围手术期联合治疗的现状。
IF 11.6 1区 医学
Liver Cancer Pub Date : 2025-04-29 DOI: 10.1159/000546138
Takahiro Nishio, Tomoaki Yoh, Hiroto Nishino, Satoshi Ogiso, Yoichiro Uchida, Takamichi Ishii, Etsuro Hatano
{"title":"Current Perspectives on Perioperative Combination Therapy for Hepatocellular Carcinoma.","authors":"Takahiro Nishio, Tomoaki Yoh, Hiroto Nishino, Satoshi Ogiso, Yoichiro Uchida, Takamichi Ishii, Etsuro Hatano","doi":"10.1159/000546138","DOIUrl":"10.1159/000546138","url":null,"abstract":"<p><strong>Background: </strong>Multidisciplinary treatment of hepatocellular carcinoma (HCC) has made notable advancements with the emergence of novel agents for systemic therapies, including receptor tyrosine kinase inhibitors (TKIs) and cancer immuno-oncology (IO) therapy utilizing immune checkpoint inhibitors. Although each of these regimens is effective as monotherapy for advanced HCCs, combining them with locoregional therapy (LRT), such as transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), and radiotherapy (RT), provides an additional antitumor effect. The emergence of novel systemic therapies has given rise to anticipation for the development of multidisciplinary treatments with a combination of systemic therapy and LRT, which aim to achieve curative-intent resection and improve long-term prognosis after resection.</p><p><strong>Summary: </strong>Perioperative combination therapy, a combination of multiple treatment modalities including systemic therapy (TKI and/or IO) and LRT (TACE, HAIC, or RT), is attracting attention as a potentially useful approach for multidisciplinary curative-intent surgical resection or ablation. Currently, there is no evidence-based guidance regarding selection criteria and optimal regimens for perioperative combination therapy. The definition of oncological resectability for HCC is being pursued to establish the indication and protocol for perioperative combination therapy, which broadly encompasses conversion as well as neoadjuvant and adjuvant therapy for intermediate-to-advanced HCC.</p><p><strong>Key messages: </strong>Perioperative combination therapy, which positions curative-intent surgical resection or ablation within the combination of multiple modalities including systemic therapy and LRT, provides perspectives for improving the long-term prognosis of patients with initially unresectable HCC and borderline resectable HCC with a high risk of recurrence.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":"1-21"},"PeriodicalIF":11.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting Survival Outcomes in Patients with Hepatocellular Carcinoma Receiving Lenvatinib by Using the Up7-ALBI Score. 使用Up7-ALBI评分预测接受Lenvatinib的肝细胞癌患者的生存结局
IF 11.6 1区 医学
Liver Cancer Pub Date : 2025-04-29 DOI: 10.1159/000546185
Chien-Hung Lu, Wei-Yu Kao, Chih-Horng Wu, Wei-Yi Ting, Chia-Hsun Lu, Kai-I Chuang, Cheng-Fu Ni, Yao-Yu Hsieh, Ming-Shun Wu, Chien-Wei Su, San-Chi Chen
{"title":"Predicting Survival Outcomes in Patients with Hepatocellular Carcinoma Receiving Lenvatinib by Using the Up7-ALBI Score.","authors":"Chien-Hung Lu, Wei-Yu Kao, Chih-Horng Wu, Wei-Yi Ting, Chia-Hsun Lu, Kai-I Chuang, Cheng-Fu Ni, Yao-Yu Hsieh, Ming-Shun Wu, Chien-Wei Su, San-Chi Chen","doi":"10.1159/000546185","DOIUrl":"10.1159/000546185","url":null,"abstract":"<p><strong>Introduction: </strong>Lenvatinib effectively manages unresectable hepatocellular carcinoma (HCC). Current prognostic models do not integrate tumor burden with liver function. By combining the Up-to-7 criteria and the albumin-bilirubin (ALBI) grade, we developed the Up7-ALBI score, a novel scoring system for predicting survival outcomes in patients with unresectable HCC receiving lenvatinib.</p><p><strong>Methods: </strong>This multicenter, retrospective study analyzed 205 patients with unresectable HCC. Tumor burden and liver function were assessed using the up-to-7 criteria and the ALBI grade, respectively. Cox proportional-hazards models evaluated their impact on survival. The Up7-ALBI score was developed to categorize patients into distinct prognostic groups. Its prognostic value was validated in a cohort of HCC patients receiving immunotherapy.</p><p><strong>Results: </strong>The overall response rate (assessed as per the Response Evaluation Criteria in Solid Tumors [RECIST] 1.1 criteria) was 13.2%. This rate was significantly higher for patients without metastases (18.6%) and those with a radiologic tumor burden within the up-to-7 criteria (22.7%). The median progression-free survival and overall survival (OS) were 7.3 and 12.2 months, respectively. Exceeding the up-to-7 criteria (hazard ratio [HR]: 1.61; 95% confidence interval [CI]: 1.00-2.57) and an ALBI grade of 2 or 3 (HR: 1.62; 95% CI: 1.06-2.47) emerged as independent risk factors of OS. A novel Up7-ALBI score stratified patients into low-, intermediate-, and high-risk groups for survival (30.8 vs. 14.2 vs. 9.3 months; <i>p</i> < 0.01). A validation cohort of 58 HCC patients with immunotherapy showed the consistent prognostic value of Up7-ALBI score. The Akaike information criterion value of the Cox proportional-hazards model for BCLC stage, ALBI grade, and Up7-ALBI score was 1,203, 1,174, and 1,170, respectively.</p><p><strong>Conclusion: </strong>The Up7-ALBI score, incorporating tumor burden and liver function, effectively stratified survival outcomes in HCC patients treated with lenvatinib. Further validation in larger cohorts and across different systemic therapies is required to confirm its broad clinical applicability.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":"1-14"},"PeriodicalIF":11.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Survival Benefit of Hepatectomy after Complete or Partial Response to Conversion Therapy in Unresectable Hepatocellular Carcinoma (GUIDANCE003): A Multicenter Study. 不可切除肝细胞癌转换治疗完全或部分缓解后肝切除术的生存获益(GUIDANCE003):一项多中心研究
IF 11.6 1区 医学
Liver Cancer Pub Date : 2025-04-23 DOI: 10.1159/000546052
Da-Long Yang, Ning Peng, Jun-Liang Nong, Kang Chen, Ze Su, Ya-Qun Yu, Lin Ye, Fan-Jian Zeng, Shao-Ping Liu, Yi-He Yan, Xue-Yao Wang, Hong-Bing Yao, Fu-Quan Yang, Wen-Feng Li, Chuang Qin, Ming-Song Wu, Yong-Yu Yang, Xiao-Feng Dong, Mian-Jing Li, Jie Liu, Yong-Rong Liang, Pei-Sheng Wu, Teng-Meng Zhong, Yong-Cheng Lai, Yao-Zhi Chen, Qing-Qing Pang, Guo-Dong Wang, Fu-Xin Li, Xian-Shuang Mao, Shu-Chang Chen, Jun-Jie Ou, Rong-Rui Huo, Xiu-Mei Liang, Bang-De Xiang, Liang Ma, Jian-Hong Zhong
{"title":"Survival Benefit of Hepatectomy after Complete or Partial Response to Conversion Therapy in Unresectable Hepatocellular Carcinoma (GUIDANCE003): A Multicenter Study.","authors":"Da-Long Yang, Ning Peng, Jun-Liang Nong, Kang Chen, Ze Su, Ya-Qun Yu, Lin Ye, Fan-Jian Zeng, Shao-Ping Liu, Yi-He Yan, Xue-Yao Wang, Hong-Bing Yao, Fu-Quan Yang, Wen-Feng Li, Chuang Qin, Ming-Song Wu, Yong-Yu Yang, Xiao-Feng Dong, Mian-Jing Li, Jie Liu, Yong-Rong Liang, Pei-Sheng Wu, Teng-Meng Zhong, Yong-Cheng Lai, Yao-Zhi Chen, Qing-Qing Pang, Guo-Dong Wang, Fu-Xin Li, Xian-Shuang Mao, Shu-Chang Chen, Jun-Jie Ou, Rong-Rui Huo, Xiu-Mei Liang, Bang-De Xiang, Liang Ma, Jian-Hong Zhong","doi":"10.1159/000546052","DOIUrl":"10.1159/000546052","url":null,"abstract":"<p><strong>Introduction: </strong>Uncertainty exists regarding whether hepatectomy enhances the prognosis for initially unresectable hepatocellular carcinoma (HCC) that becomes resectable subsequent to conversion therapy. This study conducted a comparative analysis of survival rates between patients who underwent hepatectomy and those who did not, following complete or partial response to conversion therapy.</p><p><strong>Methods: </strong>This retrospective study examined 300 patients with HCC who underwent hepatectomy following conversion therapy, along with 265 nonsurgical control subjects (215 receiving locoregional/systemic therapy and 50 under active surveillance) across 20 Chinese medical centers from 2019 to 2023. The primary outcomes assessed included overall survival (OS), event-free survival (EFS), recurrence-free survival, and the rate of complete pathological response.</p><p><strong>Results: </strong>Hepatectomy was associated with significantly better OS than locoregional or systemic therapy or active surveillance (the 3-year OS rates were 79.9% and 58.5%, respectively, <i>p</i> < 0.001) but comparable EFS (median: 40.6 vs 33.4 months, <i>p</i> = 0.403). These results were confirmed after analyzing subgroups matched to each other based on propensity scoring. Among patients who underwent hepatectomy, those who responded completely to conversion therapy showed significantly better OS than those who responded partially (HR: 0.40, 95% CI: 0.21-0.75) as well as significantly better EFS (HR: 0.45, 95% CI: 0.29-0.70). Among patients who did not undergo hepatectomy, OS and EFS were comparable between those who responded partially and those who responded completely to conversion therapy. Additionally, locoregional or systemic therapy showed significantly better results in terms of OS and EFS compared to active surveillance. Of the patients who underwent hepatectomy, 116 (38.7%) showed complete pathological response. In patients underwent hepatectomy, those who experienced complete pathological response showed significantly better OS than those who did not (HR: 0.34, 95% CI: 0.18-0.65) as well as significantly better recurrence-free survival (HR: 0.38, 95% CI: 0.25-0.59).</p><p><strong>Conclusions: </strong>Hepatectomy can provide a significant OS benefit to patients with initially unresectable HCC that responds partially or completely to conversion therapy.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":"1-17"},"PeriodicalIF":11.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of Gadoxetic Acid-Enhanced Liver Magnetic Resonance Imaging and Contrast-Enhanced Computed Tomography for the Noninvasive Diagnosis of Hepatocellular Carcinoma. 加多etic酸增强肝磁共振成像与增强ct对肝细胞癌无创诊断的比较。
IF 11.6 1区 医学
Liver Cancer Pub Date : 2025-04-22 DOI: 10.1159/000545965
Jeong Hee Yoon, Won Chang, Young Kon Kim, Chang Hee Lee, Jeong Woo Kim, Beom Jin Park, Jin-Young Choi, Seung-Seob Kim, Hee Sun Park, Eun Sun Lee, Jeong-Sik Yu, Seong Jin Park, Myung-Won You, Myoung-Jin Jang, Joon-Il Choi, Jeong Min Lee
{"title":"Comparison of Gadoxetic Acid-Enhanced Liver Magnetic Resonance Imaging and Contrast-Enhanced Computed Tomography for the Noninvasive Diagnosis of Hepatocellular Carcinoma.","authors":"Jeong Hee Yoon, Won Chang, Young Kon Kim, Chang Hee Lee, Jeong Woo Kim, Beom Jin Park, Jin-Young Choi, Seung-Seob Kim, Hee Sun Park, Eun Sun Lee, Jeong-Sik Yu, Seong Jin Park, Myung-Won You, Myoung-Jin Jang, Joon-Il Choi, Jeong Min Lee","doi":"10.1159/000545965","DOIUrl":"10.1159/000545965","url":null,"abstract":"<p><strong>Introduction: </strong>Magnetic resonance imaging (MRI) has been shown to outperform computed tomography (CT) in diagnosing hepatocellular carcinoma (HCC), although inconsistencies exist across studies. We compared the performance of CT and gadoxetic acid-enhanced MRI in diagnosing HCC according to various guidelines, and to assess the incremental value of a second-line examination.</p><p><strong>Methods: </strong>This retrospective multicenter study included patients at risk of developing HCC with focal liver lesions (FLLs) ≥10 mm. These patients underwent both contrast-enhanced CT and gadoxetic acid-enhanced MRI between January 2015 and June 2018. Four radiologists independently assessed the images using criteria from the Liver Imaging Reporting and Data System (LI-RADS), the Asian Pacific Association for the Study of the Liver (APASL), and the Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) guidelines. The diagnostic performance of CT and MRI was compared across guidelines.</p><p><strong>Results: </strong>In total, 1,590 FLLs (median size, 22.6 mm) were analyzed in 1,455 patients (median age, 59 years; male, 1,101). Sensitivity was higher with MRI than with CT for APASL (89.3% [95% CI: 87.7%, 90.8%] vs. 78.9% [95% CI: 77.0%, 80.8%], respectively) and KLCA-NCC (78.7% [95% CI: 76.7%, 85.0%] vs. 73.7% [95% CI: 71.6%, 75.7%], respectively) (<i>p</i> = 0.002 for both). However, LI-RADS showed lower sensitivity with MRI than with CT (70.6% [95% CI: 68.4%, 72.6%] vs. 74.7% [95% CI: 72.6%, 76.7%], <i>p</i> = 0.002), due to fewer nonperipheral washout. MRI re-categorized 22.4%, 32.2%, and 53.5% of non-HCC observations on CT as HCC with LI-RADS, KLCA-NCC, and APASL, respectively. CT re-classified 30.2%, 29.0%, and 25.8% of non-HCC observations on MRI as HCC with LI-RADS, KLCA-NCC, and APASL, respectively.</p><p><strong>Conclusion: </strong>The added value of gadoxetic acid-enhanced MRI after CT depends on the diagnostic criteria used. Restricting washout timing to the portal venous phase in LI-RADS reduces the sensitivity of gadoxetic acid-enhanced MRI relative to CT.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":"1-13"},"PeriodicalIF":11.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Matching-Adjusted Indirect Comparison of Arterial FOLFOX and Atezolizumab-Bevacizumab in Unresectable Hepatocellular Carcinoma. 动脉FOLFOX与阿特唑单抗-贝伐单抗治疗不可切除肝癌的间接比较
IF 11.6 1区 医学
Liver Cancer Pub Date : 2025-04-22 DOI: 10.1159/000545891
Yi-Min Zhang, Xin-Tong Wu, Jun-Zhe Yi, Jie Xu, Yu-Nan Zhang, Ning Lyu, Ming Zhao
{"title":"Matching-Adjusted Indirect Comparison of Arterial FOLFOX and Atezolizumab-Bevacizumab in Unresectable Hepatocellular Carcinoma.","authors":"Yi-Min Zhang, Xin-Tong Wu, Jun-Zhe Yi, Jie Xu, Yu-Nan Zhang, Ning Lyu, Ming Zhao","doi":"10.1159/000545891","DOIUrl":"10.1159/000545891","url":null,"abstract":"<p><strong>Introduction: </strong>A previous phase 3 FOHAIC-1 study demonstrated that hepatic arterial infusion chemotherapy (HAIC) of FOLFOX regimen displayed favorable outcomes in advanced hepatocellular carcinoma (HCC) patients, including those with high-risk features (main portal tumor invasion and >50% liver infiltration). This study aimed to compare the treatment efficacy of HAIC-FOLFOX versus atezolizumab-bevacizumab in HCC patients.</p><p><strong>Methods: </strong>Individual patient data from the Chinese FOHAIC-1 study and aggregate data from the global IMbrave150 study were used to conduct an anchored matching-adjusted indirect comparison. Hazard ratios (HR) and restricted mean survival times (RMST) were calculated to assess survival differences. Landmark analysis was performed to evaluate time-sensitive treatment effects, and simulated treatment comparison (STC) was conducted as a sensitivity analysis. Rates of treatment-related adverse events (TRAEs) and TRAE-related discontinuations were also compared.</p><p><strong>Results: </strong>After matching baseline characteristics, HAIC showed a numerical OS benefit (HR 0.57, 95% CI, 0.30-1.08) and similar PFS benefit (HR 0.79, 95% CI, 0.43-1.47) compared to atezolizumab-bevacizumab in the overall population. In high-risk patients, HAIC demonstrated significantly improved OS (HR 0.30, 95% CI, 0.12-0.72) and 2.89-month longer RMST compared to atezolizumab-bevacizumab (95% CI, 0.15-5.64 months). Additionally, HAIC showed superior PFS (HR 0.25, 95% CI, 0.10-0.64) and 2.88-month longer RMST over atezolizumab-bevacizumab (95% CI, 0.90-4.86). Landmark analysis in the high-risk group revealed that HAIC was associated with significant improvements in both OS (HR 0.32, 95% CI, 0.13-0.79) and PFS (HR 0.24, 95% CI, 0.09-0.63) during the 0-12 months following treatment initiation. Sensitivity analysis using the anchored STC analysis yielded consistent results. HAIC was associated with lower rates of grade 3-4 TRAEs and TRAE-related discontinuation in both the overall population and the high-risk group.</p><p><strong>Conclusion: </strong>HAIC treatment provided superior survival benefits and a favorable safety profile compared to atezolizumab-bevacizumab in high-risk HCC patients.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":"1-18"},"PeriodicalIF":11.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12113427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Detection of Circulating mRNA Variants in Hepatocellular Carcinoma Patients Using Targeted RNAseq. 靶向RNAseq检测肝癌患者循环mRNA变异。
IF 11.6 1区 医学
Liver Cancer Pub Date : 2025-04-04 DOI: 10.1159/000545366
Daniel Zezulinski, Maarouf A Hoteit, David E Kaplan, Angela Simeone, Tingting Zhan, Cataldo Doria, Fowsiyo Y Ahmed, Lewis R Roberts, Timothy M Block, Aejaz Sayeed
{"title":"Detection of Circulating mRNA Variants in Hepatocellular Carcinoma Patients Using Targeted RNAseq.","authors":"Daniel Zezulinski, Maarouf A Hoteit, David E Kaplan, Angela Simeone, Tingting Zhan, Cataldo Doria, Fowsiyo Y Ahmed, Lewis R Roberts, Timothy M Block, Aejaz Sayeed","doi":"10.1159/000545366","DOIUrl":"https://doi.org/10.1159/000545366","url":null,"abstract":"<p><strong>Introduction: </strong>Mutations in circulating nucleic acids can be used as biomarkers for the early detection and management of hepatocellular carcinoma (HCC). However, while circulating tumor DNA and microRNA have been extensively explored, circulating tumor mRNA and circulating mRNA mutants (ctmutRNA), which may provide advantages over other analytes, remain less well described. We previously reported the identification of 288 HCC selective ctmutRNA variants, called \"candidates,\" from a small cohort of HCC patients using total RNAseq. The objective of the current study was to use targeted RNAseq to validate the specificity and sensitivity of these HCC selective variants in an independent cohort of patients with liver cirrhosis (LC).</p><p><strong>Methods: </strong>Several methods to isolate small extracellular vesicles and amplify mRNA from the circulation were compared. RNA was isolated, and the primers and probes selective for the 288 regions of interest were used with RNA from HCC (<i>N</i> = 50) and LC and no HCC (<i>N</i> = 35) patients. HCC tumor tissues (<i>N</i> = 11), a normal liver tissue and 3 cell lines were also studied. cDNA synthesis was followed by library construction using QIAseq RNA Fusion XP panel. QC analysis was carried out with an Agilent Bioanalyzer before sequencing on a NextSeq 550 instrument. A GATK HaplotypeCaller was used for variant calling and annotation carried out using snpEff.</p><p><strong>Results: </strong>Among the test panel of 288 ctmutRNA candidates in the original cohort, 75 were detected in the new cohort of plasma samples. Moreover, 388 other variants in proximity to the original lesions were also found in multiple HCC but not LC plasma samples. A subset of 36 HCC selective variants was able to identify all HCC patients. The most common tumor specific variants were Indels and SNPs. Novel mRNA fusion variants, corresponding to SENP7, HYI, SAR1A, RASA2, TUBA transcripts, etc., were identified in HCC and LC patients.</p><p><strong>Conclusion: </strong>Circulating RNA could be a robust analyte for noninvasive early detection of HCC and circulating RNA panels could be powerful tools in the entire spectrum of clinical management.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":"1-32"},"PeriodicalIF":11.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of Efficacy between Lenvatinib and Bevacizumab in Combination of Immune Checkpoint Inhibitor and Interventional Triple Therapy in Chinese Advanced Hepatocellular Carcinoma: The CLEAP 2302 Study. Lenvatinib和Bevacizumab联合免疫检查点抑制剂和介入三联疗法治疗中国晚期肝细胞癌的疗效比较:CLEAP 2302研究
IF 11.6 1区 医学
Liver Cancer Pub Date : 2025-04-03 DOI: 10.1159/000545545
Zhaolong Pan, Dongming Liu, Junbo Cao, Linlin Fu, Xihao Zhang, Xiaodong Zhu, Yangxun Pan, Jianwei Liu, Chuangye Han, Renan Jin, Shunli Shen, Xiaoyun Zhang, Hongzhi Liu, Xiaobo Yang, Kuan Hu, Xiaoyi Shi, Dongxu Wang, Yang Zhao, Jianhong Zhong, Bangde Xiang, Shanzhi Gu, Tao Li, Shuijun Zhang, Ledu Zhou, Haitao Zhao, Yongyi Zeng, Tianfu Wen, Ming Kuang, Xiao Liang, Tao Peng, Kui Wang, Li Xu, Huikai Li, Tianqiang Song, Huichuan Sun, Wei Zhang
{"title":"Comparison of Efficacy between Lenvatinib and Bevacizumab in Combination of Immune Checkpoint Inhibitor and Interventional Triple Therapy in Chinese Advanced Hepatocellular Carcinoma: The CLEAP 2302 Study.","authors":"Zhaolong Pan, Dongming Liu, Junbo Cao, Linlin Fu, Xihao Zhang, Xiaodong Zhu, Yangxun Pan, Jianwei Liu, Chuangye Han, Renan Jin, Shunli Shen, Xiaoyun Zhang, Hongzhi Liu, Xiaobo Yang, Kuan Hu, Xiaoyi Shi, Dongxu Wang, Yang Zhao, Jianhong Zhong, Bangde Xiang, Shanzhi Gu, Tao Li, Shuijun Zhang, Ledu Zhou, Haitao Zhao, Yongyi Zeng, Tianfu Wen, Ming Kuang, Xiao Liang, Tao Peng, Kui Wang, Li Xu, Huikai Li, Tianqiang Song, Huichuan Sun, Wei Zhang","doi":"10.1159/000545545","DOIUrl":"10.1159/000545545","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The conversion therapy for advanced hepatocellular carcinoma (HCC) shows promise with a triple therapy approach that combines interventional therapy, immune checkpoint inhibitors, and molecular targeted therapy (primarily small-molecule TKIs and the large-molecule bevacizumab). This combination has achieved the highest objective response rates (ORR) along with acceptable safety profiles. The aim of this study was to compare the clinical efficacy of lenvatinib versus bevacizumab, when combined with immune checkpoint inhibitors and interventional triple therapy, as first-line treatments for Chinese patients with unresectable HCC (uHCC).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;This retrospective multicenter study involved 371 consecutive patients from 21 centers in China, observed between April 2017 and December 2023. The study focused on patients with uHCC at Chinese liver cancer stages IIb to IIIb (Barcelona Clinic Liver Cancer stage B or C) who received lenvatinib or bevacizumab combined with anti-PD-1/L1 and interventional therapy (including TACE and/or HAIC) as first-line treatment. Of the 371 patients, 258 received lenvatinib-based triple therapy, while 113 received bevacizumab-based triple therapy. The primary endpoints were overall survival (OS) and progression-free survival (PFS). To balance baseline clinical characteristics, propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied. Subgroup analysis was also performed based on different clinicopathological characteristics of the enrolled uHCC patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The median OS in the lenvatinib group was significantly longer than in the bevacizumab group, both before (36.0 vs. 27.9 months; hazard ratio [HR]: 0.536; 95% confidence interval [CI]: 0.344-0.835; &lt;i&gt;p&lt;/i&gt; = 0.0016) and after PSM (HR: 0.524; 95% CI: 0.305-0.900; &lt;i&gt;p&lt;/i&gt; = 0.01), as well as after IPTW (HR: 0.549; 95% CI: 0.331-0.908; &lt;i&gt;p&lt;/i&gt; = 0.01). Before adjustment, PFS in the lenvatinib group was also significantly longer than in the bevacizumab group (20.0 vs. 12.1 months; HR: 0.649; 95% CI: 0.457-0.922; &lt;i&gt;p&lt;/i&gt; = 0.0078). However, after PSM (HR: 0.808; 95% CI: 0.535-1.222; &lt;i&gt;p&lt;/i&gt; = 0.33) and IPTW, there was no significant difference in PFS between the two groups. Multivariate analysis showed that lenvatinib-based triple therapy was independently associated with improved OS compared to bevacizumab-based triple therapy. Subgroup analysis indicated that patients with age ≤65 years, no history of hepatitis B virus infection, Barcelona Clinic Liver Cancer stage C (BCLC-C), ALT levels ≤40 U/L, platelets ≥100 × 10&lt;sup&gt;9&lt;/sup&gt;/L, or log 10 AFP ≥1.40 benefited more from lenvatinib-based triple therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Lenvatinib-based triple therapy tends to prolong OS compared to bevacizumab, although the PFS was similar between the two groups. Patients aged ≤65 years, without a history of hepatitis B virus infection, with B","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":"1-19"},"PeriodicalIF":11.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Immune Checkpoint Inhibitor plus Anti-VEGF/TKI Combined with Transarterial Chemoembolization in Locally Advanced Nonmetastatic Hepatocellular Carcinoma: Real-World Treatment Strategy Based on Phase 3 Clinical Trial Results. 免疫检查点抑制剂联合抗vegf /TKI联合经动脉化疗栓塞治疗局部晚期非转移性肝癌:基于3期临床试验结果的现实世界治疗策略
IF 11.6 1区 医学
Liver Cancer Pub Date : 2025-03-29 eCollection Date: 2025-06-01 DOI: 10.1159/000545594
Masatoshi Kudo
{"title":"Immune Checkpoint Inhibitor plus Anti-VEGF/TKI Combined with Transarterial Chemoembolization in Locally Advanced Nonmetastatic Hepatocellular Carcinoma: Real-World Treatment Strategy Based on Phase 3 Clinical Trial Results.","authors":"Masatoshi Kudo","doi":"10.1159/000545594","DOIUrl":"10.1159/000545594","url":null,"abstract":"","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 3","pages":"241-247"},"PeriodicalIF":11.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Current Surveillance Strategy Is Less Effective for Detecting Early-Stage Hepatocellular Carcinoma in Patients with Non-Viral and Non-Cirrhotic Liver Disease. 目前的监测策略在非病毒性和非肝硬化肝病患者中检测早期肝细胞癌的效果较差。
IF 11.6 1区 医学
Liver Cancer Pub Date : 2025-03-26 DOI: 10.1159/000542805
Jessica Spiers, Wenhao Li, Aloysious D Aravinthan, Ayman Bannaga, Katharine Caddick, Emma L Culver, Rosemary E Faulkes, Victoria Gordon, Yaqza Hussain, Hamish Miller, Jenny Merry, Muhammad Saad, Abhishek Sheth, Tahir Shah, Shishir Shetty, Ankur Srivastava, Mohsan Subhani, Muhammad Nauman Tahir, Nwe Ni Than, Esther Unitt, William Alazawi
{"title":"Current Surveillance Strategy Is Less Effective for Detecting Early-Stage Hepatocellular Carcinoma in Patients with Non-Viral and Non-Cirrhotic Liver Disease.","authors":"Jessica Spiers, Wenhao Li, Aloysious D Aravinthan, Ayman Bannaga, Katharine Caddick, Emma L Culver, Rosemary E Faulkes, Victoria Gordon, Yaqza Hussain, Hamish Miller, Jenny Merry, Muhammad Saad, Abhishek Sheth, Tahir Shah, Shishir Shetty, Ankur Srivastava, Mohsan Subhani, Muhammad Nauman Tahir, Nwe Ni Than, Esther Unitt, William Alazawi","doi":"10.1159/000542805","DOIUrl":"https://doi.org/10.1159/000542805","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths. Current international guidelines recommend 6-monthly ultrasound surveillance in all patients with cirrhosis and those with hepatitis B virus-related risk factors to detect early-stage HCC. However, it is unknown whether the benefits of surveillance are comparable across patient groups and underlying disease-related factors. We aimed to evaluate patient- and disease-related factors associated with HCC stage at diagnosis and survival in an ethnically diverse UK population.</p><p><strong>Methods: </strong>This was a multicentre retrospective observational study including patients with newly diagnosed HCC between 2007 and 2020 from six UK centres. Cox proportional-hazards regression and multivariate logistic regression models were used.</p><p><strong>Results: </strong>Overall, 1,780 HCC patients comprising 20.9% with ArLD, 29.7% with NAFLD, and 31.0% with viral hepatitis were analysed. Surveillance was associated with improved survival in patients with viral hepatitis but not in patients with ArLD and NAFLD. Surveillance was also associated with early-stage disease (BCLC stage 0 or A) at presentation in viral hepatitis but not in patients with ArLD. Females with ArLD were 2.5-fold more likely to present with early-stage HCC than males. Patients with NAFLD were more likely to develop HCC in the absence of cirrhosis. Type 2 diabetes was not associated with mortality, but metformin use did show survival benefit. Patients of white ethnicity had improved survival and were less likely to present with late-stage HCC compared to other ethnicities.</p><p><strong>Conclusions: </strong>HCC surveillance as currently delivered was less effective for detecting early-stage HCC in patients with non-viral and non-cirrhotic liver disease. Gender and ethnicity influences stage at presentation and outcomes. HCC surveillance strategies are needed to refine risk stratification particularly in patients with NAFLD or without cirrhosis.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":"1-14"},"PeriodicalIF":11.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment Decision-Making in Unresectable Hepatocellular Carcinoma: Importance of Understanding the Different Response Patterns between IO plus Anti-VEGF and IO plus IO Regimens. 不可切除肝细胞癌的治疗决策:了解IO +抗vegf和IO + IO方案不同反应模式的重要性。
IF 11.6 1区 医学
Liver Cancer Pub Date : 2025-03-07 eCollection Date: 2025-04-01 DOI: 10.1159/000545163
Masatoshi Kudo
{"title":"Treatment Decision-Making in Unresectable Hepatocellular Carcinoma: Importance of Understanding the Different Response Patterns between IO plus Anti-VEGF and IO plus IO Regimens.","authors":"Masatoshi Kudo","doi":"10.1159/000545163","DOIUrl":"https://doi.org/10.1159/000545163","url":null,"abstract":"","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 2","pages":"119-126"},"PeriodicalIF":11.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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