Oncology最新文献

{"title":"Efficacy of Fusion Imaging and Cone-Beam Computed Tomography Guided Radiofrequency Ablation for Hepatocellular Carcinoma Poorly Visualized on Ultrasonography.","authors":"Keizo Kato, Hiroshi Abe, Makiko Ika, Yuhi Sakamoto, Mizuki Takeuchi, Shingo Komazaki, Shinichiro Takeda, Sadahiro Ito, Shohei Shimizu, Ryota Matsuo","doi":"10.1159/000546427","DOIUrl":"https://doi.org/10.1159/000546427","url":null,"abstract":"<p><strong>Introduction: </strong>Radiofrequency ablation (RFA) generally involves the insertion of a radiofrequency electrode into the hepatocellular carcinoma (HCC) nodule under ultrasonography (US) guidance. However, the procedure is often not feasible for patients whose HCC is undetectable on conventional US. Advances in imaging technology, such as fusion imaging (FI) and cone-beam computed tomography (CBCT), may enhance treatment precision and efficacy for these challenging cases. This study assessed the efficacy of RFA guided by FI and CBCT in managing HCC poorly visualized on ultrasonography US.</p><p><strong>Methods: </strong>HCC nodules were classified into GOOD (clearly delineated), POOR (poorly delineated), and NONE (undetectable) based on US visualization. All nodules underwent RFA guided by FI and CBCT either in combination with transcatheter arterial chemoembolization (TACE) or without TACE. The technical success rate and local tumor progression post-RFA were evaluated using dynamic contrast-enhanced imaging. Between-group differences were analyzed retrospectively.</p><p><strong>Results: </strong>A total of 420 patients with 595 HCC nodules were enrolled. Complete ablation rates were 91.4%, 94.9%, and 86.2% in the GOOD, POOR, and NONE groups, respectively. For nodules with over 50% lipiodol accumulation, the complete ablation rates were 91.5%, 96.5%, and 88.8%; for those with less than 50% lipiodol accumulation, they were 95.5%, 100%, and 62.5%; and for those without lipiodol accumulation, they were 89.5%, 77.8%, and 82.4% in the GOOD, POOR, and NONE groups, respectively. Significant factors associated with complete ablation included larger nodule size and lipiodol accumulation. Cumulative local tumor progression rates at 1 year were 4.5%, 0%, and 3.8%, with no significant differences among groups.</p><p><strong>Conclusion: </strong>FI and CBCT guidance effectively achieve local control for HCC, including nodules poorly visualized on US, with outcomes comparable to US-visible nodules, especially for those with lipiodol accumulation.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-21"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-HER2 therapies in biliary tract cancers: A meta-analysis on disease location, HER2 status, and survival outcomes.","authors":"Silvia Camera, Margherita Rimini, Silvia Foti, Federica Lo Prinzi, Francesco Vitiello, Elisabeth Amadeo, Mara Persano, Stefano Cascinu, Andrea Casadei-Gardini, Federico Rossari","doi":"10.1159/000545308","DOIUrl":"https://doi.org/10.1159/000545308","url":null,"abstract":"<p><p>Introduction In recent years, the therapeutic scenario of metastatic biliary tract cancers (BTC) beyond first-line has profoundly changed owing to target therapies. HER2 represents a promising molecular target that is frequently altered in BTC. The present meta-analyses are aimed to describe the response rates and survival outcomes in patients with HER2-positive locally advanced/metastatic BTC treated with anti-HER2 therapies. Moreover, the study is intended to provide an update on the evolving therapeutic scenario of HER2 overexpressed BTC. Methods We performed a systematic review of the literature to identify clinical trials investigating any regimen comprising a HER2 targeted therapy for metastatic BTC, and we conducted three subsequent meta-analyses on second-line phase II trials. The first one was performed to compare the group of HER2 3+ versus the group of HER2 2+ BTC patients for objective response rate (ORR). The second one compared patients according to the tumor location (gallbladder carcinoma [GBC] or extrahepatic cholangiocarcinoma [eCCA] versus intrahepatic cholangiocarcinoma [iCCA]) for ORR. The third one evaluated the overall outcomes in terms of overall survival (OS) and progression-free survival (PFS). Results Patients with advanced BTC and HER2 3+ had better ORR compared to HER2 2+, with a 3.7-fold higher probability of experiencing objective responses (HR 3.70, 95% CI 1.34-10.25, p=0.0119). Likewise, patients with GBC or eCCA had a 2.74-fold higher probability of experiencing an objective response compared to patients with iCCA (HR 2.74, 95% CI 1.12-6.73, p=0.0275). The weighted pooled analysis of trials with anti-HER2 agents in second-line or beyond revealed a mPFS of 4.9 months (95% CI 4.2-5.6), while mOS was 10.8 months (95% CI 9.0-12.8). Conclusions Our meta-analyses have revealed improved efficacy in patients with HER2 3+ metastatic BTC and in patients with GBC or eCCA treated with anti-HER2 therapies, with a considerable mPFS and mOS in the overall population of the phase II trials analyzed. Further studies are paramount to confirm our preliminary results.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-20"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to TACE and TARE with respect to region and urbanity in the United States: a large retrospective healthcare claims database study.","authors":"Nathan Sim, John T Moon, Hanzhou Li, Nicholas Lima, Zachary Bercu, Janice Newsome","doi":"10.1159/000546514","DOIUrl":"https://doi.org/10.1159/000546514","url":null,"abstract":"<p><p>Access to highly specialized interventional oncology procedures such as transarterial chemoembolization (TACE) and radioembolization (TARE) may be limited in non-metropolitan areas of the United States. This study characterizes the distribution of these procedures across regions by metropolitan status through utilization of a large commercial healthcare claims database (Truven Merative Marketscan). Patients with a diagnosis of primary hepatocellular carcinoma (HCC) (n= 41,280) were categorized into those who received TACE (n = 1,780) or TARE (n = 1,179). Chi-squared tests of association were utilized to analyze regional data. Statistical analyses showed significant differences between most regional comparisons with most patients receiving these procedures originating from metropolitan areas overall. Though limited to TACE and TARE, this study reveals a disparate distribution of TACE and TARE utilization across regions with preference towards metropolitan over non-metropolitan areas, which may represent a barrier for access to care for nonmetropolitan patients, though this remains to be studied.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-11"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Number of Tumors Stratifies the Therapeutic Response to Atezolizumab Plus Bevacizumab Therapy in Barcelona Clinic Liver Cancer Stage B Unresectable Hepatocellular Carcinoma: A Multicenter Analysis.","authors":"Takanori Suzuki, Kentaro Matsuura, Daisuke Kato, Katsumi Hayashi, Kohei Okayama, Fumihiro Okumura, Satoshi Sobue, Atsunori Kusakabe, Izumi Hasegawa, Kiyoto Narita, Tsutomu Mizoshita, Yoshihide Kimura, Ryo Sato, Hiromu Kondo, Atsushi Ozasa, Hayato Kawamura, Kei Fujiwara, Shunsuke Nojiri, Hiromi Kataoka","doi":"10.1159/000546515","DOIUrl":"https://doi.org/10.1159/000546515","url":null,"abstract":"<p><strong>Introduction: </strong>Atezolizumab plus bevacizumab (ATZ+BV) is used for the treatment of Barcelona Clinic Liver Cancer (BCLC) stage B unresectable hepatocellular carcinoma (u-HCC) patients. However, the efficacy of ATZ+BV in various BCLC stage B conditions, especially the up-to-seven criteria in/out, has not been fully investigated.</p><p><strong>Methods: </strong>We enrolled 83 BCLC stage B u-HCC patients with Child-Pugh class A who were treated with ATZ+BV as the first-line systemic chemotherapy in the study. All patients were evaluated for initial responses by dynamic computed tomography or magnetic resonance imaging after the initiation of ATZ+BV, and therapeutic efficacy was assessed.</p><p><strong>Results: </strong>When stratified by up-to-seven criteria, progression-free survival (PFS) was significantly prolonged in patients with up-to-seven in (in vs. out: median 21.0 vs. 8.2 months, P = 0.006), and the Cox proportional hazard model showed that up-to-seven out/in was the significant factor contributing to PFS (out vs. in: HR 2.58, P = 0.007). We next evaluated PFS stratified by the maximum intrahepatic tumor diameter and number of intrahepatic tumors, which constitute the up-to-seven criteria. The number of tumors was a significant factor contributing to PFS (> 7 vs. ≤ 7: HR 1.75, P = 0.040), but maximum tumor size was not (> 5 cm vs. ≤ 5 cm: HR 1.19, P = 0.588).</p><p><strong>Conclusions: </strong>In BCLC stage B u-HCC patients treated with ATZ+BV, a high number of intrahepatic tumors was associated with poor PFS. Therefore, it may be better to consider additional treatment strategies in these patients.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-18"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endogenous and extracellular roles of a tumor suppressor miR-379-5p in gastric cancer.","authors":"Michelle Xin Liu, Kent-Man Chu","doi":"10.1159/000546620","DOIUrl":"https://doi.org/10.1159/000546620","url":null,"abstract":"<p><strong>Introduction: </strong>MiRNAs play important roles in development of various cancers including gastric cancer. Exosomes are extracellular vesicles for translocating molecules. This study aims to investigate the tumor suppressive roles of miR-379-5p in gastric cancer, and to investigate the roles of exosomes in transporting miR-379-5p from intracellular to extracellular.</p><p><strong>Methods: </strong>Fifty-three pairs of gastric cancer and non-tumor tissue samples were collected. Five cell lines were applied. Functional assays including cell proliferation, cell migration and invasion, and cell adhesion assay were performed. Targets of miR-379-5p were screened and validated by western blot. Expressions of endogenous miR-379-5p in gastric cancer cells and exosomal miR-379-5p in cell culture medium were evaluated by RT-qPCR. Medium of culturing AGS or BCG23 was applied for culturing MKN45 and HEK293T.</p><p><strong>Results: </strong>The results indicated that miR-379-5p was significantly downregulated in gastric cancer tissue samples and cell lines. Enforced expression of miR-379-5p inhibited gastric cancer cell proliferation, migration, and invasion, while miR-379-5p mimic enhanced cell adhesion to extracellular matrix. IGF1R was a potential target of miR-379-5p in gastric cancer. Expression of miR-379-5p was dramatically higher in exosomes in cell culture medium than its endogenous expression. Exosomes from cell culture medium of AGS or BCG23 could regulate endogenous expression of miR-379-5p in HEK293T cells.</p><p><strong>Conclusions: </strong>MiR-379-5p was significantly downregulated and it functioned as a tumor suppressor in gastric cancer. MiR-379-5p was higher expressed in exosomes of culture medium than its endogenous expression. MiR-379-5p could be translocated from cells into cell culture medium and entered certain cell types via exosomes.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-16"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of modified Glasgow Prognostic Score in patients undergoing FOLFOXIRI plus bevacizumab therapy for advanced or metastatic colorectal cancer.","authors":"Koji Numata, Yukari Ono, Kenta Iguchi, Mamoru Uchiyama, Masahiro Asari, Keisuke Kazama, Norio Yukawa, Aya Saito, Manabu Shiozawa","doi":"10.1159/000546260","DOIUrl":"https://doi.org/10.1159/000546260","url":null,"abstract":"<p><strong>Introduction: </strong>The prognostic value of the modified Glasgow Prognostic Score (mGPS), a systemic inflammatory response marker, has been reported in various cancers. However, its role in patients with metastatic colorectal cancer (mCRC) undergoing first-line FOLFOXIRI + bevacizumab (BV) therapy remains unclear. In this study, we aimed to evaluate the prognostic significance of pretreatment mGPS and other inflammatory markers in this patient population.</p><p><strong>Methods: </strong>This study retrospectively reviewed 133 patients with mCRC treated with first-line FOLFOXIRI + BV. We assessed the prognostic value of pretreatment mGPS and other inflammatory markers (NLR, PLR, LMR) in relation to progression-free survival (PFS) and overall survival (OS).</p><p><strong>Results: </strong>Higher mGPS (score 2) was significantly associated with poor PFS and OS. Multivariate analysis identified mGPS 2 as an independent predictor of worse PFS (hazard ratio 2.76, p = 0.004) and OS (hazard ratio 3.43, p < 0.001). No significant associations were found between other inflammatory markers and survival outcomes.</p><p><strong>Conclusions: </strong>Pretreatment mGPS is a simple and useful prognostic factor for mCRC patients receiving FOLFOXIRI + BV therapy and may serve as a convenient indicator for accurate prognosis prediction and treatment decision-making.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-22"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From development to implementation: a systematic review on the current maturity status of artificial intelligence models for patients with colorectal cancer liver metastases.","authors":"Ruby Kemna, J Michiel Zeeuw, Kirsten A Ziesemer, Mahsoem Ali, Jacqueline I Bereska, Henk Marquering, Jaap Stoker, Inez M Verpalen, Rutger-Jan Swijnenburg, Joost Huiskens, Geert Kazemier","doi":"10.1159/000546572","DOIUrl":"https://doi.org/10.1159/000546572","url":null,"abstract":"<p><p>Introduction Artificial intelligence (AI) is increasingly being researched and developed in the medical field and holds potential to transform healthcare after successful implementation. For patients with colorectal cancer liver metastases (CRLM), many AI models have been developed, but knowledge about translation of these models in the clinical workflow is lacking. Therefore, this systematic review aims to provide a contemporary overview of the current maturity status of AI models for patients with CRLM. Methods A systematic search of the literature until November 2, 2023 was conducted in PubMed, Embase.com and Clarivate Analytics/Web of Science Core Collection to identify eligible studies. Studies using AI and/or radiomics for patients with CRLM were considered eligible. Data on the study aim, study design, size of dataset, country, type of AI application, level of validation and clinical implementation status (NASA technology readiness levels) were collected. Risk of bias and applicability of the individual studies were evaluated using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). Results A total of 117 studies were included. Ninety-seven studies (83%) were published in the last five years. The most common study design was retrospective (96%). Thirty-five studies (30%) utilized a dataset of fewer than 50 patients with CRLM. Internal validation was performed in 63% of studies, external validation in 17%. The remaining studies did not report validation. Half of the studies were classified as high risk of bias. None of the included studies performed real-time testing, workflow integration, clinical testing or clinical integration. Conclusion Although a rapid increase in research describing the development of AI models for patients with CRLM is observed in recent years, not a single AI model has been translated into clinical practice.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-25"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin and Immune-Related Cardiovascular Events in Lung Cancer Patients Receiving Immune Checkpoint Inhibitors.","authors":"Junmin Song, Kuan-Yu Chi, Hyein Jeon, Yu-Cheng Chang, Nutchapon Xanthavanij, Zhiting Tang, Yu Chang, Cho-Hung Chiang, Yu-Shiuan Lin, Shuwen Lin, Xiaocao Haze Xu, Cho-Han Chiang","doi":"10.1159/000546204","DOIUrl":"https://doi.org/10.1159/000546204","url":null,"abstract":"<p><strong>Backgrounds: </strong>Immune checkpoint inhibitors (ICIs) have improved lung cancer treatment but are associated with an increased risk of cardiotoxicity. We investigated whether statins could mitigate ICI-associated cardiovascular risks in lung cancer patients.</p><p><strong>Methods: </strong>We performed a retrospective, propensity score-matched cohort study utilizing the TriNetX database. We identified lung cancer patients receiving ICIs between April 2013 and June 2023. We created two cohorts: statin users and non-users. The primary efficacy outcome was major adverse cardiovascular events (MACE), defined as a composite of myocardial infarction, ischemic stroke, and heart failure. The secondary efficacy outcomes were myocarditis and cardiac arrest. Safety outcomes were all-cause mortality and serious immune-related adverse events (irAEs).</p><p><strong>Results: </strong>A total of 16,650 lung cancer patients undergoing ICIs were identified, consisting of 6,812 statin users and 9,838 non-users. After propensity score matching, 4,379 patients were well-matched in baseline characteristics. Over a follow-up period of 12 months, statin use was associated with a lower risk of MACE (HR: 0.87, 95% CI: 0.78-0.98), primarily driven by reductions in myocardial infarction (HR: 0.75, 95% CI: 0.58-0.97) and heart failure (HR: 0.85, 95% CI: 0.74-0.98). For safety outcomes, statin use was associated with a reduction in all-cause mortality (HR: 0.83, 95% CI: 0.77-0.90) and did not result in an increased risk of serious irAEs.</p><p><strong>Conclusions: </strong>The use of statins in lung cancer patients with cardiovascular risk factors and without previous cardiovascular events undergoing immunotherapy was associated with a reduction in MACE and all-cause mortality without an increased risk of serious adverse events.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-14"},"PeriodicalIF":2.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified albumin-bilirubin grade and alpha-fetoprotein score for predicting prognosis of hepatocellular carcinoma patients undergoing conventional transarterial chemoembolization.","authors":"Manabu Hayashi, Kazumichi Abe, Tatsuro Sugaya, Naoto Abe, Yosuke Takahata, Masashi Fujita, Hiromasa Ohira","doi":"10.1159/000546334","DOIUrl":"https://doi.org/10.1159/000546334","url":null,"abstract":"<p><strong>Background: </strong>Predicting post-treatment prognosis in hepatocellular carcinoma (HCC) patients undergoing conventional transarterial chemoembolization (cTACE) is challenging due to tumor heterogeneity. We here assessed the utility of the modified albumin‒bilirubin grade and α-fetoprotein (mALF) score for predicting the prognosis of cTACE-treated HCC patients.</p><p><strong>Methods: </strong>This retrospective observational study included 206 early- and intermediate-stage HCC patients who had undergone cTACE. We calculated baseline and post-treatment mALF scores by assigning one point for a modified albumin-bilirubin grade of 2b or 3, and one point for an alpha-fetoprotein level of ≥ 100 ng/mL.</p><p><strong>Results: </strong>The baseline mALF scores were 0, 1, and 2 points for 66 patients (32%), 95 patients (47%), and 45 patients (21%), respectively, and their median survival times were 42.3 months, 21.1 months, and 14.0 months, respectively. The baseline mALF score was also associated with overall survival, independent of the Barcelona Clinic Liver Cancer stage and the tumor burden score (hazard ratio, 1.97; 95% confidence interval, 1.56-2.49; p < 0.001). One month after cTACE, the mALF score had decreased in 26 patients and increased in 31 patients. In those with a baseline mALF score of 0 or 1, the increased mALF score was significantly associated with shorter survival periods after cTACE.</p><p><strong>Conclusions: </strong>The baseline mALF score was useful in stratifying HCC patients undergoing cTACE, according to post-treatment prognosis. Increased mALF scores after cTACE were associated with poor prognosis in patients with a baseline mALF score of 0 or 1. Assessment of baseline and post-treatment mALF scores may help in predicting prognosis in HCC patients following cTACE.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-17"},"PeriodicalIF":2.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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.","authors":"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","doi":"10.1159/000546211","DOIUrl":"https://doi.org/10.1159/000546211","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>LRTs may provide a viable option for managing oligo-drug-resistant lesions during first-line atezo/bev therapy for unresectable HCC when safely administered.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-23"},"PeriodicalIF":2.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}