Predictive biomarkers of survival in patients with advanced hepatocellular carcinoma receiving atezolizumab plus bevacizumab treatment
Abstract Background Since atezolizumab plus bevacizumab (ATE+BEV) regimen for patients with unresectable hepatocellular carcinoma (HCC) was released quite recently, real‐world data are lacking. We evaluated efficacy, safety, and predictive biomarkers for survival in patients receiving ATE+BEV. Metho...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-02-01
|
| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.5161 |
| _version_ | 1797903129009717248 |
|---|---|
| author | Young Eun Chon Jaekyung Cheon Hyeyeong Kim Beodeul Kang Yeonjung Ha Do young Kim Seong Gyu Hwang Hong Jae Chon Beom Kyung Kim |
| author_facet | Young Eun Chon Jaekyung Cheon Hyeyeong Kim Beodeul Kang Yeonjung Ha Do young Kim Seong Gyu Hwang Hong Jae Chon Beom Kyung Kim |
| author_sort | Young Eun Chon |
| collection | DOAJ |
| description | Abstract Background Since atezolizumab plus bevacizumab (ATE+BEV) regimen for patients with unresectable hepatocellular carcinoma (HCC) was released quite recently, real‐world data are lacking. We evaluated efficacy, safety, and predictive biomarkers for survival in patients receiving ATE+BEV. Methods Between 2020 and 2021, HCC patients receiving ATE+BEV at academic teaching hospitals were recruited. Treatment response was assessed using the Response Evaluation Criteria in Solid Tumors (version 1.1.). Results Among 121 patients enrolled, the median age was 63 years, with male predominance (82.6%). Complete response, partial response, stable disease, and progressive disease were identified in 2.5%, 26.4%, 54.5%, and 16.6%, respectively. Patients with alpha‐fetoprotein and des‐gamma‐carboxy prothrombin (DCP) response, defined as ≥30% and ≥50% decreases, respectively, at the first response evaluation relative to baseline, and those with neutrophil‐to‐lymphocyte ratio (NLR) <2.5, had significantly higher objective response rates (42.6% vs. 21.5%, 50.0% vs. 26.2%, and 39.0% vs. 19.4%, respectively; all p < 0.05). During follow‐up, the median overall survival (OS) was not reached, and the median progression‐free survival (PFS) was 5.7 months. Multivariable analyses showed that macrovascular invasion (adjusted hazard ratio [aHR] 2.541; p = 0.017), DCP ≥186 mAU/ml (aHR 5.102; p < 0.001), NLR ≥2.5 (aHR 3.584; p = 0.001), and an NLR decrease ≥10% at the first response (aHR 0.305; p = 0.002) were independent predictors of OS, and DCP ≥186 mAU (aHR 2.311; p = 0.002) and NLR ≥2.5 (aHR 1.938; p = 0.012) were independent predictors of PFS. Grade ≥3 treatment‐related adverse events (AEs) occurred in 33 (27.3%) patients. Conclusion ATE+BEV showed favorable efficacy and safety. Baseline high DCP and NLR may be useful prognostic predictors for OS and PFS. |
| first_indexed | 2024-04-10T09:28:05Z |
| format | Article |
| id | doaj.art-c690d06944f842d99adbb9a58d194898 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-10T09:28:05Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-c690d06944f842d99adbb9a58d1948982023-02-19T18:54:07ZengWileyCancer Medicine2045-76342023-02-011232731273810.1002/cam4.5161Predictive biomarkers of survival in patients with advanced hepatocellular carcinoma receiving atezolizumab plus bevacizumab treatmentYoung Eun Chon0Jaekyung Cheon1Hyeyeong Kim2Beodeul Kang3Yeonjung Ha4Do young Kim5Seong Gyu Hwang6Hong Jae Chon7Beom Kyung Kim8Department of Gastroenterology, CHA Bundang Medical Center CHA University Seongnam Republic of KoreaDepartment of Medical oncology CHA Bundang Medical Center, CHA University Seongnam Republic of KoreaDepartment of Internal Medicine Ulsan University Hospital, University of Ulsan College of Medicine Ulsan Republic of KoreaDepartment of Medical oncology CHA Bundang Medical Center, CHA University Seongnam Republic of KoreaDepartment of Gastroenterology, CHA Bundang Medical Center CHA University Seongnam Republic of KoreaDepartment of Internal Medicine Yonsei University College of Medicine Seoul Republic of KoreaDepartment of Internal Medicine Ulsan University Hospital, University of Ulsan College of Medicine Ulsan Republic of KoreaDepartment of Medical oncology CHA Bundang Medical Center, CHA University Seongnam Republic of KoreaDepartment of Internal Medicine Yonsei University College of Medicine Seoul Republic of KoreaAbstract Background Since atezolizumab plus bevacizumab (ATE+BEV) regimen for patients with unresectable hepatocellular carcinoma (HCC) was released quite recently, real‐world data are lacking. We evaluated efficacy, safety, and predictive biomarkers for survival in patients receiving ATE+BEV. Methods Between 2020 and 2021, HCC patients receiving ATE+BEV at academic teaching hospitals were recruited. Treatment response was assessed using the Response Evaluation Criteria in Solid Tumors (version 1.1.). Results Among 121 patients enrolled, the median age was 63 years, with male predominance (82.6%). Complete response, partial response, stable disease, and progressive disease were identified in 2.5%, 26.4%, 54.5%, and 16.6%, respectively. Patients with alpha‐fetoprotein and des‐gamma‐carboxy prothrombin (DCP) response, defined as ≥30% and ≥50% decreases, respectively, at the first response evaluation relative to baseline, and those with neutrophil‐to‐lymphocyte ratio (NLR) <2.5, had significantly higher objective response rates (42.6% vs. 21.5%, 50.0% vs. 26.2%, and 39.0% vs. 19.4%, respectively; all p < 0.05). During follow‐up, the median overall survival (OS) was not reached, and the median progression‐free survival (PFS) was 5.7 months. Multivariable analyses showed that macrovascular invasion (adjusted hazard ratio [aHR] 2.541; p = 0.017), DCP ≥186 mAU/ml (aHR 5.102; p < 0.001), NLR ≥2.5 (aHR 3.584; p = 0.001), and an NLR decrease ≥10% at the first response (aHR 0.305; p = 0.002) were independent predictors of OS, and DCP ≥186 mAU (aHR 2.311; p = 0.002) and NLR ≥2.5 (aHR 1.938; p = 0.012) were independent predictors of PFS. Grade ≥3 treatment‐related adverse events (AEs) occurred in 33 (27.3%) patients. Conclusion ATE+BEV showed favorable efficacy and safety. Baseline high DCP and NLR may be useful prognostic predictors for OS and PFS.https://doi.org/10.1002/cam4.5161atezolizumabbevacizumabhepatocellular carcinomaneutrophil to lymphocyte ratiodes‐gamma‐carboxy prothrombin |
| spellingShingle | Young Eun Chon Jaekyung Cheon Hyeyeong Kim Beodeul Kang Yeonjung Ha Do young Kim Seong Gyu Hwang Hong Jae Chon Beom Kyung Kim Predictive biomarkers of survival in patients with advanced hepatocellular carcinoma receiving atezolizumab plus bevacizumab treatment Cancer Medicine atezolizumab bevacizumab hepatocellular carcinoma neutrophil to lymphocyte ratio des‐gamma‐carboxy prothrombin |
| title | Predictive biomarkers of survival in patients with advanced hepatocellular carcinoma receiving atezolizumab plus bevacizumab treatment |
| title_full | Predictive biomarkers of survival in patients with advanced hepatocellular carcinoma receiving atezolizumab plus bevacizumab treatment |
| title_fullStr | Predictive biomarkers of survival in patients with advanced hepatocellular carcinoma receiving atezolizumab plus bevacizumab treatment |
| title_full_unstemmed | Predictive biomarkers of survival in patients with advanced hepatocellular carcinoma receiving atezolizumab plus bevacizumab treatment |
| title_short | Predictive biomarkers of survival in patients with advanced hepatocellular carcinoma receiving atezolizumab plus bevacizumab treatment |
| title_sort | predictive biomarkers of survival in patients with advanced hepatocellular carcinoma receiving atezolizumab plus bevacizumab treatment |
| topic | atezolizumab bevacizumab hepatocellular carcinoma neutrophil to lymphocyte ratio des‐gamma‐carboxy prothrombin |
| url | https://doi.org/10.1002/cam4.5161 |
| work_keys_str_mv | AT youngeunchon predictivebiomarkersofsurvivalinpatientswithadvancedhepatocellularcarcinomareceivingatezolizumabplusbevacizumabtreatment AT jaekyungcheon predictivebiomarkersofsurvivalinpatientswithadvancedhepatocellularcarcinomareceivingatezolizumabplusbevacizumabtreatment AT hyeyeongkim predictivebiomarkersofsurvivalinpatientswithadvancedhepatocellularcarcinomareceivingatezolizumabplusbevacizumabtreatment AT beodeulkang predictivebiomarkersofsurvivalinpatientswithadvancedhepatocellularcarcinomareceivingatezolizumabplusbevacizumabtreatment AT yeonjungha predictivebiomarkersofsurvivalinpatientswithadvancedhepatocellularcarcinomareceivingatezolizumabplusbevacizumabtreatment AT doyoungkim predictivebiomarkersofsurvivalinpatientswithadvancedhepatocellularcarcinomareceivingatezolizumabplusbevacizumabtreatment AT seonggyuhwang predictivebiomarkersofsurvivalinpatientswithadvancedhepatocellularcarcinomareceivingatezolizumabplusbevacizumabtreatment AT hongjaechon predictivebiomarkersofsurvivalinpatientswithadvancedhepatocellularcarcinomareceivingatezolizumabplusbevacizumabtreatment AT beomkyungkim predictivebiomarkersofsurvivalinpatientswithadvancedhepatocellularcarcinomareceivingatezolizumabplusbevacizumabtreatment |