Cancer Medicine (Oct 2022)
Safety and efficacy of atezolizumab plus bevacizumab in elderly patients with hepatocellular carcinoma: A multicenter analysis
- Toshifumi Tada,
- Takashi Kumada,
- Atsushi Hiraoka,
- Masashi Hirooka,
- Kazuya Kariyama,
- Joji Tani,
- Masanori Atsukawa,
- Koichi Takaguchi,
- Ei Itobayashi,
- Shinya Fukunishi,
- Kunihiko Tsuji,
- Toru Ishikawa,
- Kazuto Tajiri,
- Hironori Ochi,
- Satoshi Yasuda,
- Hidenori Toyoda,
- Chikara Ogawa,
- Takashi Nishimura,
- Takeshi Hatanaka,
- Satoru Kakizaki,
- Noritomo Shimada,
- Kazuhito Kawata,
- Takaaki Tanaka,
- Hideko Ohama,
- Kazuhiro Nouso,
- Asahiro Morishita,
- Akemi Tsutsui,
- Takuya Nagano,
- Norio Itokawa,
- Tomomi Okubo,
- Taeang Arai,
- Michitaka Imai,
- Atsushi Naganuma,
- Yohei Koizumi,
- Shinichiro Nakamura,
- Kouji Joko,
- Hiroko Iijima,
- Yoichi Hiasa,
- the Real‐life Practice Experts for HCC (RELPEC) Study Group and the Hepatocellular Carcinoma Experts from 48 clinics in Japan (HCC 48) Group
Affiliations
- Toshifumi Tada
- Department of Internal Medicine Japanese Red Cross Himeji Hospital Himeji Japan
- Takashi Kumada
- Department of Nursing Gifu Kyoritsu University Japan
- Atsushi Hiraoka
- Gastroenterology Center Ehime Prefectural Central Hospital Matsuyama Japan
- Masashi Hirooka
- Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine Ehime Japan
- Kazuya Kariyama
- Department of Gastroenterology Okayama City Hospital Okayama Japan
- Joji Tani
- Department of Gastroenterology and Hepatology Kagawa University Kagawa Japan
- Masanori Atsukawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Nippon Medical School Tokyo Japan
- Koichi Takaguchi
- Department of Hepatology Kagawa Prefectural Central Hospital Takamatsu Japan
- Ei Itobayashi
- Department of Gastroenterology Asahi General Hospital Asahi Japan
- Shinya Fukunishi
- Premier Departmental Research of Medicine Osaka Medical and Pharmaceutical University Osaka Japan
- Kunihiko Tsuji
- Center of Gastroenterology Teine Keijinkai Hospital Sapporo Japan
- Toru Ishikawa
- Department of Gastroenterology Saiseikai Niigata Hospital Niigata Japan
- Kazuto Tajiri
- Department of Gastroenterology Toyama University Hospital Toyama Japan
- Hironori Ochi
- Center for Liver‐Biliary‐Pancreatic Disease Matsuyama Red Cross Hospital Matsuyama Japan
- Satoshi Yasuda
- Department of Gastroenterology and Hepatology Ogaki Municipal Hospital Japan
- Hidenori Toyoda
- Department of Gastroenterology and Hepatology Ogaki Municipal Hospital Japan
- Chikara Ogawa
- Department of Gastroenterology Japanese Red Cross Takamatsu Hospital Takamatsu Japan
- Takashi Nishimura
- Department of Internal medicine, Division of Gastroenterology and Hepatology Hyogo College of Medicine Nishinomiya Japan
- Takeshi Hatanaka
- Department of Gastroenterology Gunma Saiseikai Maebashi Hospital Maebashi Japan
- Satoru Kakizaki
- Department of Clinical Research National Hospital Organization Takasaki General Medical Center Takasaki Japan
- Noritomo Shimada
- Division of Gastroenterology and Hepatology Otakanomori Hospital Kashiwa Japan
- Kazuhito Kawata
- Department of Internal Medicine II Hamamatsu University School of Medicine Hamamatsu Japan
- Takaaki Tanaka
- Gastroenterology Center Ehime Prefectural Central Hospital Matsuyama Japan
- Hideko Ohama
- Premier Departmental Research of Medicine Osaka Medical and Pharmaceutical University Osaka Japan
- Kazuhiro Nouso
- Department of Gastroenterology Okayama City Hospital Okayama Japan
- Asahiro Morishita
- Department of Gastroenterology and Hepatology Kagawa University Kagawa Japan
- Akemi Tsutsui
- Department of Hepatology Kagawa Prefectural Central Hospital Takamatsu Japan
- Takuya Nagano
- Department of Hepatology Kagawa Prefectural Central Hospital Takamatsu Japan
- Norio Itokawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Nippon Medical School Tokyo Japan
- Tomomi Okubo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Nippon Medical School Tokyo Japan
- Taeang Arai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Nippon Medical School Tokyo Japan
- Michitaka Imai
- Department of Gastroenterology Saiseikai Niigata Hospital Niigata Japan
- Atsushi Naganuma
- Department of Gastroenterology National Hospital Organization Takasaki General Medical Center Takasaki Japan
- Yohei Koizumi
- Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine Ehime Japan
- Shinichiro Nakamura
- Department of Internal Medicine Japanese Red Cross Himeji Hospital Himeji Japan
- Kouji Joko
- Center for Liver‐Biliary‐Pancreatic Disease Matsuyama Red Cross Hospital Matsuyama Japan
- Hiroko Iijima
- Department of Internal medicine, Division of Gastroenterology and Hepatology Hyogo College of Medicine Nishinomiya Japan
- Yoichi Hiasa
- Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine Ehime Japan
- the Real‐life Practice Experts for HCC (RELPEC) Study Group and the Hepatocellular Carcinoma Experts from 48 clinics in Japan (HCC 48) Group
- DOI
- https://doi.org/10.1002/cam4.4763
- Journal volume & issue
-
Vol. 11,
no. 20
pp. 3796 – 3808
Abstract
Abstract Aim The safety and efficacy of atezolizumab plus bevacizumab (Atez/Bev) in elderly patients with unresectable hepatocellular carcinoma (HCC) have not been sufficiently investigated. Methods A total of 317 patients with HCC treated with Atez/Bev were studied. We compared the survival and frequency of adverse events in elderly versus non‐elderly patients with HCC who were treated with Atez/Bev using an analysis of inverse probability weighting (IPW). Results Univariate analysis adjusted with IPW showed that being elderly is not associated with worse overall or progression‐free survival (hazard ratio [HR], 1.239; 95% confidence interval [CI], 0.640–2.399; p = 0.526 and HR, 1.256; 95% CI, 0.871–1.811; p = 0.223, respectively). Regarding treatment‐related adverse events, any grade of fatigue, proteinuria, decreased appetite, hypertension, and liver injury occurred in ≥10% of patients. There were no significant differences in treatment‐related adverse events between the elderly and non‐elderly groups. In a subgroup analysis of elderly patients aged 75–79, 80–84, or ≥ 85 years, there were no significant differences in cumulative overall or progression‐free survival among these age groups (p = 0.960 and 0.566, respectively). In addition, there were no significant differences in treatment‐related adverse events among these three age groups, except for proteinuria of any grade. In a subgroup analysis of patients treated with Atez/Bev as first‐line systemic therapy, there were no significant differences in cumulative overall or progression‐free survival between the elderly and non‐elderly groups (p = 0.728 and 0.805, respectively). Conclusions Atez/Bev can be used efficaciously and safely in spite of age in patients with unresectable HCC.
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