阿特唑单抗联合贝伐单抗治疗hcv相关不可切除肝细胞癌的持续病毒学反应对预后的影响有限。

IF 1.8 3区医学 Q3 ONCOLOGY

Oncology Pub Date : 2025-08-08 DOI:10.1159/000547353

Hideko Ohama, Atsushi Hiraoka, Toshifumi Tada, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Hidenori Toyoda, Yuichi Koshiyama, Chikara Ogawa, Hiroki Nishikawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Hidenao Noritake, Kazuhito Kawata, Atsushi Naganuma, Hisashi Kosaka, Kosuke Matsui, Tomomitsu Matono, Hidekatsu Kuroda, Yutaka Yata, Hironori Tanaka, Tomoko Aoki, Hideyuki Tamai, Fujimasa Tada, Yuki Kanayama, Kazunari Tanaka, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Taeang Arai, Teruki Miyake, Osamu Yoshida, Michitaka Imai, Shinichiro Nakamura, Hirayuki Enomoto, Masaki Kaibori, Masatoshi Kudo, Yoichi Hiasa, Takashi Kumada

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引用次数: 0

摘要

目的：持续病毒学反应（SVR）是治疗丙型肝炎病毒（HCV）引起的肝细胞癌（HCC）患者的一个有利预后因素。本研究旨在评估SVR对阿特唑单抗联合贝伐单抗（Atez/Bev）治疗HCV引起的不可切除HCC （uHCC）的影响。方法：回顾性分析2020年9月- 2025年4月接受Atez/Bev治疗的364例uHCC患者，分为SVR组（n=284）和非SVR组（n=80），比较临床特征、预后和不良事件。结果：各组在年龄、性别、血小板计数、AFP、BCLC分期等方面无显著差异。然而，SVR组表现出更好的ALBI评分（-2.50 vs -2.16），更低的AST （33 vs. 57 IU/L）和ALT （23 vs. 40 IU/L）水平(结论：尽管SVR与更好的生存率没有独立关联，但SVR患者保留了肝功能，并且经历了更少的不良事件。这些因素可能间接支持在Atez/Bev治疗hcv相关的uHCC期间改善耐受性和治疗选择。

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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Limited Prognostic Impact of Sustained Virologic Response on Atezolizumab plus Bevacizumab Therapy for HCV-Related Unresectable Hepatocellular Carcinoma.

Aims: Sustained virological response (SVR) is a favorable prognostic factor for patients with hepatocellular carcinoma (HCC) caused by hepatitis C virus (HCV) treated curatively. This study aimed to evaluate the impact of SVR on atezolizumab plus bevacizumab (Atez/Bev) therapy for unresectable HCC (uHCC) caused by HCV.

Methods: A retrospective analysis of 364 uHCC patients treated with Atez/Bev (September 2020-April 2025) and divided into SVR (n = 284) and non-SVR (n = 80) groups was performed, with clinical characteristics, prognosis, and adverse events compared.

Results: There were no significant differences between the groups for age, sex, platelet count, AFP, or BCLC stage. However, the SVR group showed a significantly better ALBI score (-2.50 vs. -2.16) and lower AST (33 vs. 57 IU/L) and ALT (23 vs. 40 IU/L) levels (p < 0.01). Median progression-free survival (PFS) was 7.1 months in the SVR group and 6.1 months in the non-SVR group (p = 0.443), and median overall survival (OS) was 20.9 months in the SVR group and 18.9 months in the non-SVR group, with no significant differences between the groups (p = 0.560). Following IPW adjustment for factors related to OS, there was no significant difference regarding PFS (p = 0.921) and OS (p = 0.927). Multivariate analysis identified age ≥75 years and poor hepatic function (mALBI grade 2b/3) as independent predictors of poor OS; SVR status was not an independent factor. Changes in ALBI and Child-Pugh scores over time were not significantly different between the groups. In the non-SVR group, adverse events were more common as compared to the SVR group, including liver dysfunction (27.5% vs. 13.0%, p < 0.001) and edema/ascites (12.5% vs. 9.2%, p = 0.015).

Conclusions: Although SVR was not independently associated with better survival, patients with SVR had preserved liver function and experienced fewer adverse events. These factors may indirectly support improved tolerability and therapeutic options during Atez/Bev therapy for HCV-related uHCC.

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来源期刊

Oncology 医学-肿瘤学

CiteScore

6.00

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： 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.