Cancer Medicine (Dec 2023)
Comparing the impact of atezolizumab plus bevacizumab and lenvatinib on the liver function in hepatocellular carcinoma patients: A mixed‐effects regression model approach
- 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,
- Keisuke Yokohama,
- Hiroki Nishikawa,
- Takashi Nishimura,
- Noritomo Shimada,
- Kazuhito Kawata,
- Hisashi Kosaka,
- Atsushi Naganuma,
- Yutaka Yata,
- Hideko Ohama,
- Hidekatsu Kuroda,
- Kazunari Tanaka,
- Takaaki Tanaka,
- Fujimasa Tada,
- Kazuhiro Nouso,
- Asahiro Morishita,
- Akemi Tsutsui,
- Takuya Nagano,
- Norio Itokawa,
- Tomomi Okubo,
- Taeang Arai,
- Michitaka Imai,
- Yohei Koizumi,
- Shinichiro Nakamura,
- Masaki Kaibori,
- Hiroko Iijima,
- Yoichi Hiasa,
- Masatoshi Kudo,
- 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 Matsuyama Japan
- Kazuya Kariyama
- Department of Gastroenterology, Okayama City Hospital Okayama Japan
- Joji Tani
- Department of Gastroenterology and Neurology Kagawa University Kita‐gun 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
- Department of Gastroenterology, Division of Hepatobiliary and Pancreatic Diseases Hyogo Medical University Nishinomiya 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
- Keisuke Yokohama
- Department of Gastroenterology Osaka Medical and Pharmaceutical University Osaka Japan
- Hiroki Nishikawa
- Department of Gastroenterology Osaka Medical and Pharmaceutical University Osaka Japan
- Takashi Nishimura
- Department of Gastroenterology, Division of Hepatobiliary and Pancreatic Diseases Hyogo Medical University 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
- Atsushi Naganuma
- Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center Takasaki Japan
- Yutaka Yata
- Department of Gastroenterology, Hanwa Memorial Hospital Osaka Japan
- Hideko Ohama
- Department of Gastroenterology, Takarazuka City Hospital Takarazuka Japan
- Hidekatsu Kuroda
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Iwate Medical University Iwate Japan
- Kazunari Tanaka
- Center of Gastroenterology, Teine Keijinkai Hospital Sapporo Japan
- Takaaki Tanaka
- Gastroenterology Center, Ehime Prefectural Central Hospital Matsuyama Japan
- Fujimasa Tada
- Gastroenterology Center, Ehime Prefectural Central Hospital Matsuyama Japan
- Kazuhiro Nouso
- Department of Gastroenterology, Okayama City Hospital Okayama Japan
- Asahiro Morishita
- Department of Gastroenterology and Neurology Kagawa University Kita‐gun 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
- Yohei Koizumi
- Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine Matsuyama Japan
- Shinichiro Nakamura
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital Himeji Japan
- Masaki Kaibori
- Department of Surgery Kansai Medical University Hirakata Japan
- Hiroko Iijima
- Department of Gastroenterology, Division of Hepatobiliary and Pancreatic Diseases Hyogo Medical University Nishinomiya Japan
- Yoichi Hiasa
- Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine Matsuyama Japan
- Masatoshi Kudo
- Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine Osaka 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/cam4.6726
- Journal volume & issue
-
Vol. 12,
no. 24
pp. 21680 – 21693
Abstract
Abstract Aim This retrospective study compared the impact of atezolizumab plus bevacizumab (Atez/Bev) and lenvatinib (LEN) on the liver function in patients with hepatocellular carcinoma. Methods We included 526 patients who received Atez/Bev and 731 who received LEN March 2018 and July 2022 in this study. We conducted a 1:1 propensity‐score‐matched analysis and identified 324 patients in each group for inclusion in the present analysis. Nonlinear mixed‐effects regression models were employed, allowing for the evaluation and inclusion of cases where treatment was interrupted due to disease progression, adverse events, or loss to follow‐up. These models were used to compare the ALBI score between the Atez/Bev and LEN groups. Results Following propensity score matching, the mean ALBI scores in the Atez/Bev and LEN groups were −2.41 ± 0.40 and −2.44 ± 0.42 at baseline, and −2.17 ± 0.56 and −2.19 ± 0.58 at 12 weeks, respectively. Although the ALBI score significantly worsened during treatment in both groups (p < 0.001), there was no significant difference in the rate of ALBI score deterioration between the groups (p = 0.06). Subgroup analyses showed that LEN‐treated patients with BCLC advanced stage (p = 0.02) and those who initially received the full dose (p < 0.001) had a significantly greater worsening of ALBI score compared to Atez/Bev. Conclusions Using a nonlinear mixed‐effects regression approach, which allowed for the inclusion of cases with treatment interruption, we found no significant difference in the trend of liver function deterioration between the Atez/Bev and LEN groups. Caution should be exercised for LEN‐treated patients with BCLC advanced stage or those receiving the full dose of LEN.
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