Cancer Medicine (Mar 2023)
Comparative efficacy and safety of atezolizumab and bevacizumab between hepatocellular carcinoma patients with viral and non‐viral infection: A Japanese multicenter observational study
- Takeshi Hatanaka,
- Satoru Kakizaki,
- 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,
- Satoshi Yasuda,
- Hidenori Toyoda,
- Chikara Ogawa,
- Takashi Nishimura,
- Noritomo Shimada,
- Kazuhito Kawata,
- Hisashi Kosaka,
- 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,
- Masaki Kaibori,
- Hiroko Iijima,
- Yoichi Hiasa,
- Takashi Kumada,
- the Real‐life Practice Experts for HCC (RELPEC) Study Group, and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
Affiliations
- 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
- Atsushi Hiraoka
- Gastroenterology Center Ehime Prefectural Central Hospital Matsuyama Japan
- Toshifumi Tada
- Department of Internal Medicine Japanese Red Cross Himeji Hospital Himeji 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 Ogaki Japan
- Hidenori Toyoda
- Department of Gastroenterology and Hepatology Ogaki Municipal Hospital Ogaki 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
- Noritomo Shimada
- Division of Gastroenterology and Hepatology Otakanomori Hospital Kashiwa Japan
- Kazuhito Kawata
- Hepatology Division, Department of Internal Medicine II Hamamatsu University School of Medicine Hamamatsu Japan
- Hisashi Kosaka
- Department of Surgery Kansai Medical University Hirakata Japan
- Takaaki Tanaka
- Gastroenterology Center Ehime Prefectural Central Hospital Matsuyama Japan
- Hideko Ohama
- Gastroenterology Center Ehime Prefectural Central Hospital Matsuyama 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
- Masaki Kaibori
- Department of Surgery Kansai Medical University Hirakata 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
- Takashi Kumada
- Department of Nursing Gifu Kyoritsu University Ogaki Japan
- the Real‐life Practice Experts for HCC (RELPEC) Study Group, and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
- DOI
- https://doi.org/10.1002/cam4.5337
- Journal volume & issue
-
Vol. 12,
no. 5
pp. 5293 – 5303
Abstract
Abstract Aim This study compared the efficacy and safety of atezolizumab and bevacizumab (Atez/Bev) in patients with viral and non‐viral infection in clinical settings. Methods We conducted the retrospective cohort study of 323 BCLC stage B or C hepatocellular carcinoma (HCC) patients with Child‐Pugh class A, and a performance status of 0 or 1 who started Atez/Bev from September 2020 to December 2021 at 22 institutions in Japan. Patients with viral infection was defined as those who were either serum anti‐HCV‐ Ab or HBs‐Ag‐positive, while patients with non‐viral infection was defined as those who were both serum anti‐HCV Ab‐ and HBs‐Ag‐negative. We constructed a propensity‐score‐matched cohort to minimize the risk of observable potential confounders. Results Propensity score matching produced 126 matched pairs for patients with viral versus non‐viral infection. After matching, the significant differences in baseline demographic features did not exist between the two groups. The objective response rate was 20.6% and 24.6% in viral‐ and non‐viral‐related HCC patients, respectively, without a significant difference (p = 0.55). The disease control rate was not also significantly different (68.3% vs 69.0%, p = 1.00). The median progression‐free survival was 7.0 months (95% confidence interval [CI] 6.0–9.6) and 6.2 months (95% CI 5.1–7.8) in patients with viral and non‐viral infection, and the 12‐month survival rates were 65.5% (95% CI 50.8–76.8) and 71.7% (95% CI 57.3–81.9) in those with viral and non‐viral infection, respectively, which were not significantly different (p = 0.33, p = 0.38). No significant difference in treatment‐related adverse events was found between the two groups. Conclusions Our etiology‐based study demonstrated that Atez/Bev showed good efficacy and safety for HCC patient with non‐viral infection as well as those with viral infection.
Keywords
- etiology
- immune checkpoint inhibitor
- non‐alcoholic steatohepatitis
- propensity score matching
- real‐world data
