Differential liver function at cessation of atezolizumab-bevacizumab versus lenvatinib in HCC: a multicenter, propensity-score matched comparative study
BackgroundAtezolizumab+bevacizumab (AB) and lenvatinib have been proposed as first-line treatment options for patients with advanced hepatocellular carcinoma (HCC), but comparative efficacy and associated factors are controversial.Materials and methodsThis real-world multicenter study analysed patie...
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1372007/full |
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| author | Ji Won Han Ji Won Han Pil Soo Sung Pil Soo Sung Jae-Sung Yoo Jae-Sung Yoo Hee Sun Cho Hee Sun Cho Soon Kyu Lee Soon Kyu Lee Hyun Yang Hyun Yang Ji Hoon Kim Ji Hoon Kim Heechul Nam Heechul Nam Hae Lim Lee Hae Lim Lee Hee Yeon Kim Hee Yeon Kim Sung Won Lee Sung Won Lee Do Seon Song Do Seon Song Myeong Jun Song Myeong Jun Song Jung Hyun Kwon Jung Hyun Kwon Chang Wook Kim Chang Wook Kim Si Hyun Bae Si Hyun Bae Jeong Won Jang Jeong Won Jang Jong Young Choi Jong Young Choi Seung Kew Yoon Seung Kew Yoon |
| author_facet | Ji Won Han Ji Won Han Pil Soo Sung Pil Soo Sung Jae-Sung Yoo Jae-Sung Yoo Hee Sun Cho Hee Sun Cho Soon Kyu Lee Soon Kyu Lee Hyun Yang Hyun Yang Ji Hoon Kim Ji Hoon Kim Heechul Nam Heechul Nam Hae Lim Lee Hae Lim Lee Hee Yeon Kim Hee Yeon Kim Sung Won Lee Sung Won Lee Do Seon Song Do Seon Song Myeong Jun Song Myeong Jun Song Jung Hyun Kwon Jung Hyun Kwon Chang Wook Kim Chang Wook Kim Si Hyun Bae Si Hyun Bae Jeong Won Jang Jeong Won Jang Jong Young Choi Jong Young Choi Seung Kew Yoon Seung Kew Yoon |
| author_sort | Ji Won Han |
| collection | DOAJ |
| description | BackgroundAtezolizumab+bevacizumab (AB) and lenvatinib have been proposed as first-line treatment options for patients with advanced hepatocellular carcinoma (HCC), but comparative efficacy and associated factors are controversial.Materials and methodsThis real-world multicenter study analysed patients with HCC who received AB (n=169) or lenvatinib (n=177).ResultsFirst, 1:1 propensity score matching (PSM) was performed, resulting in 141 patients in both the AB and lenvatinib groups. After PSM, overall survival (OS) was better in the AB group than in the lenvatinib group [hazard ratio (HR)=0.642, P=0.009], but progression-free survival (PFS) did not vary between the two groups (HR=0.817, P=0.132). Objective response rate (ORR) was also similar between AB and lenvatinib (34.8% vs. 30.8%, P=0.581). In a subgroup of patients with objective responses (OR, n=78), OS (HR=0.364, P=0.012) and PFS (HR=0.536, P=0.019) were better in the AB group (n=41) than in the lenvatinib group (n=37). Time-to-progression from time of OR was also better in the AB group (HR=0.465, P=0.012). Importantly, residual liver function was a significant factor related to OS in both treatments. Child-Pugh score following cessation of the respective treatments was better in the AB group (n=105) than in the lenvatinib group (n=126) (median 6 versus 7, P=0.008), and proportion of salvage treatment was also higher in the AB group (52.4% versus 38.9%, P=0.047). When we adjusted for residual liver function or salvage treatment, there was no difference in OS between the two treatments.ConclusionOur study suggests that residual liver function and subsequent salvage treatments are major determinants of clinical outcomes in patients treated with AB and lenvatinib; these factors should be considered in future comparative studies. |
| first_indexed | 2024-03-07T20:06:18Z |
| format | Article |
| id | doaj.art-a5bacfced7d94a80ad9b89efcedec63c |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-07T20:06:18Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-a5bacfced7d94a80ad9b89efcedec63c2024-02-28T05:02:28ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-02-011410.3389/fonc.2024.13720071372007Differential liver function at cessation of atezolizumab-bevacizumab versus lenvatinib in HCC: a multicenter, propensity-score matched comparative studyJi Won Han0Ji Won Han1Pil Soo Sung2Pil Soo Sung3Jae-Sung Yoo4Jae-Sung Yoo5Hee Sun Cho6Hee Sun Cho7Soon Kyu Lee8Soon Kyu Lee9Hyun Yang10Hyun Yang11Ji Hoon Kim12Ji Hoon Kim13Heechul Nam14Heechul Nam15Hae Lim Lee16Hae Lim Lee17Hee Yeon Kim18Hee Yeon Kim19Sung Won Lee20Sung Won Lee21Do Seon Song22Do Seon Song23Myeong Jun Song24Myeong Jun Song25Jung Hyun Kwon26Jung Hyun Kwon27Chang Wook Kim28Chang Wook Kim29Si Hyun Bae30Si Hyun Bae31Jeong Won Jang32Jeong Won Jang33Jong Young Choi34Jong Young Choi35Seung Kew Yoon36Seung Kew Yoon37The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Bucheon St. Mary’s Hospital, The Catholic University of Korea, Bucheon, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Bucheon St. Mary’s Hospital, The Catholic University of Korea, Bucheon, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Bucheon St. Mary’s Hospital, The Catholic University of Korea, Bucheon, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaBackgroundAtezolizumab+bevacizumab (AB) and lenvatinib have been proposed as first-line treatment options for patients with advanced hepatocellular carcinoma (HCC), but comparative efficacy and associated factors are controversial.Materials and methodsThis real-world multicenter study analysed patients with HCC who received AB (n=169) or lenvatinib (n=177).ResultsFirst, 1:1 propensity score matching (PSM) was performed, resulting in 141 patients in both the AB and lenvatinib groups. After PSM, overall survival (OS) was better in the AB group than in the lenvatinib group [hazard ratio (HR)=0.642, P=0.009], but progression-free survival (PFS) did not vary between the two groups (HR=0.817, P=0.132). Objective response rate (ORR) was also similar between AB and lenvatinib (34.8% vs. 30.8%, P=0.581). In a subgroup of patients with objective responses (OR, n=78), OS (HR=0.364, P=0.012) and PFS (HR=0.536, P=0.019) were better in the AB group (n=41) than in the lenvatinib group (n=37). Time-to-progression from time of OR was also better in the AB group (HR=0.465, P=0.012). Importantly, residual liver function was a significant factor related to OS in both treatments. Child-Pugh score following cessation of the respective treatments was better in the AB group (n=105) than in the lenvatinib group (n=126) (median 6 versus 7, P=0.008), and proportion of salvage treatment was also higher in the AB group (52.4% versus 38.9%, P=0.047). When we adjusted for residual liver function or salvage treatment, there was no difference in OS between the two treatments.ConclusionOur study suggests that residual liver function and subsequent salvage treatments are major determinants of clinical outcomes in patients treated with AB and lenvatinib; these factors should be considered in future comparative studies.https://www.frontiersin.org/articles/10.3389/fonc.2024.1372007/fullHCCatezolizumab plus bevacizumablenvatinibresidual liver functionsurvival |
| spellingShingle | Ji Won Han Ji Won Han Pil Soo Sung Pil Soo Sung Jae-Sung Yoo Jae-Sung Yoo Hee Sun Cho Hee Sun Cho Soon Kyu Lee Soon Kyu Lee Hyun Yang Hyun Yang Ji Hoon Kim Ji Hoon Kim Heechul Nam Heechul Nam Hae Lim Lee Hae Lim Lee Hee Yeon Kim Hee Yeon Kim Sung Won Lee Sung Won Lee Do Seon Song Do Seon Song Myeong Jun Song Myeong Jun Song Jung Hyun Kwon Jung Hyun Kwon Chang Wook Kim Chang Wook Kim Si Hyun Bae Si Hyun Bae Jeong Won Jang Jeong Won Jang Jong Young Choi Jong Young Choi Seung Kew Yoon Seung Kew Yoon Differential liver function at cessation of atezolizumab-bevacizumab versus lenvatinib in HCC: a multicenter, propensity-score matched comparative study Frontiers in Oncology HCC atezolizumab plus bevacizumab lenvatinib residual liver function survival |
| title | Differential liver function at cessation of atezolizumab-bevacizumab versus lenvatinib in HCC: a multicenter, propensity-score matched comparative study |
| title_full | Differential liver function at cessation of atezolizumab-bevacizumab versus lenvatinib in HCC: a multicenter, propensity-score matched comparative study |
| title_fullStr | Differential liver function at cessation of atezolizumab-bevacizumab versus lenvatinib in HCC: a multicenter, propensity-score matched comparative study |
| title_full_unstemmed | Differential liver function at cessation of atezolizumab-bevacizumab versus lenvatinib in HCC: a multicenter, propensity-score matched comparative study |
| title_short | Differential liver function at cessation of atezolizumab-bevacizumab versus lenvatinib in HCC: a multicenter, propensity-score matched comparative study |
| title_sort | differential liver function at cessation of atezolizumab bevacizumab versus lenvatinib in hcc a multicenter propensity score matched comparative study |
| topic | HCC atezolizumab plus bevacizumab lenvatinib residual liver function survival |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1372007/full |
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