PMID- 38477514
OWN - NLM
STAT- MEDLINE
DCOM- 20240314
LR  - 20240315
IS  - 2045-7634 (Electronic)
IS  - 2045-7634 (Linking)
VI  - 13
IP  - 5
DP  - 2024 Mar
TI  - Efficacy and safety of atezolizumab plus bevacizumab in patients with portal 
      hypertension for unresectable hepatocellular carcinoma.
PG  - e7025
LID - 10.1002/cam4.7025 [doi]
LID - e7025
AB  - AIM: Atezolizumab plus bevacizumab combination therapy (Atezo + Beva) is used as 
      the first-line therapy for unresectable hepatocellular carcinoma (u-HCC). Serious 
      adverse events (AEs), including rupture of esophagogastric varices, have been 
      seen during treatment. Therefore, the relationships of efficacy, safety, and 
      portal hypertension (PH) were analyzed. METHODS: A total of 146 patients with 
      u-HCC and Child-Pugh Scores of 5-7 received Atezo + Beva. Prophylactic treatment 
      for varices was performed for patients with the risk of rupture of varices before 
      the start of Atezo + Beva. A propensity score-matched cohort was created to 
      minimize the risk of potential confounders. Efficacy was assessed in 41 
      propensity score-matched pairs. AEs were assessed between patients without PH 
      (n = 80) and with PH (n = 66). RESULTS: In patients without PH and with PH, 
      median overall survival was 18.4 months and 18.8 months (p = 0.71), and median 
      progression-free survival was 8.6 months and 5.8 months (p = 0.92), respectively. 
      On the best radiological response evaluation for Response Evaluation Criteria in 
      Solid Tumors, the objective response rate was 31.7% and 26.8% (p = 0.81), 
      respectively. Variceal rupture occurred in three patients with PH, but there were 
      no significant differences in the occurrence of variceal rupture (p = 0.090) and 
      Grade 3-4 AEs between patients without and with PH. CONCLUSIONS: No significant 
      differences in efficacy and safety were observed with PH. Prophylactic treatment 
      for varices before the start of Atezo + Beva would allow treatment to continue 
      relatively safely.
CI  - (c) 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
FAU - Kinami, Takahiro
AU  - Kinami T
AUID- ORCID: 0009-0003-8322-4885
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Uchikawa, Shinsuke
AU  - Uchikawa S
AUID- ORCID: 0000-0002-1538-4946
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Kawaoka, Tomokazu
AU  - Kawaoka T
AUID- ORCID: 0000-0002-1887-1096
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Yamasaki, Shintaro
AU  - Yamasaki S
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Kosaka, Masanari
AU  - Kosaka M
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Johira, Yusuke
AU  - Johira Y
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Yano, Shigeki
AU  - Yano S
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Amioka, Kei
AU  - Amioka K
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Naruto, Kensuke
AU  - Naruto K
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Yamaoka, Kenji
AU  - Yamaoka K
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Fujii, Yasutoshi
AU  - Fujii Y
AD  - Department of Clinical Oncology, Hiroshima University Hospital, Hiroshima, Japan.
FAU - Fujino, Hatsue
AU  - Fujino H
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Nakahara, Takashi
AU  - Nakahara T
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Ono, Atsushi
AU  - Ono A
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Murakami, Eisuke
AU  - Murakami E
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Okamoto, Wataru
AU  - Okamoto W
AD  - Department of Clinical Oncology, Hiroshima University Hospital, Hiroshima, Japan.
FAU - Yamauchi, Masami
AU  - Yamauchi M
AD  - Department of Clinical Oncology, Hiroshima University Hospital, Hiroshima, Japan.
FAU - Miki, Daiki
AU  - Miki D
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Tsuge, Masataka
AU  - Tsuge M
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
FAU - Oka, Shiro
AU  - Oka S
AD  - Department of Gastroenterology, Graduate School of Biomedical and Health 
      Sciences, Hiroshima University, Hiroshima, Japan.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Cancer Med
JT  - Cancer medicine
JID - 101595310
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - 52CMI0WC3Y (atezolizumab)
RN  - 0 (Antibodies, Monoclonal, Humanized)
SB  - IM
MH  - Humans
MH  - *Carcinoma, Hepatocellular
MH  - Bevacizumab
MH  - *Liver Neoplasms
MH  - *Hypertension, Portal
MH  - *Varicose Veins
MH  - *Antibodies, Monoclonal, Humanized
PMC - PMC10935873
OTO - NOTNLM
OT  - adverse events
OT  - atezolizumab plus bevacizumab
OT  - esophagogastric variceal rupture
OT  - hepatocellular carcinoma
OT  - portal hypertension
COIS- Authors declare no conflict of interests for this article.
EDAT- 2024/03/13 12:45
MHDA- 2024/03/14 06:47
PMCR- 2024/03/13
CRDT- 2024/03/13 08:34
PHST- 2023/12/20 00:00 [revised]
PHST- 2023/10/14 00:00 [received]
PHST- 2024/02/07 00:00 [accepted]
PHST- 2024/03/14 06:47 [medline]
PHST- 2024/03/13 12:45 [pubmed]
PHST- 2024/03/13 08:34 [entrez]
PHST- 2024/03/13 00:00 [pmc-release]
AID - CAM47025 [pii]
AID - 10.1002/cam4.7025 [doi]
PST - ppublish
SO  - Cancer Med. 2024 Mar;13(5):e7025. doi: 10.1002/cam4.7025.