Scientific Reports (Jul 2023)

Estimation of the effect of atezolizumab plus bevacizumab on pulmonary arterial hypertension using computed tomography in HCC patients

  • Takayuki Kondo,
  • Kisako Fujiwara,
  • Miyuki Nakagawa,
  • Kentaro Fujimoto,
  • Sae Yumita,
  • Takamasa Ishino,
  • Keita Ogawa,
  • Terunao Iwanaga,
  • Keisuke Koroki,
  • Hiroaki Kanzaki,
  • Masanori Inoue,
  • Kazufumi Kobayashi,
  • Soichiro Kiyono,
  • Masato Nakamura,
  • Naoya Kanogawa,
  • Sadahisa Ogasawara,
  • Shingo Nakamoto,
  • Tetsuhiro Chiba,
  • Jun Kato,
  • Naoya Kato

DOI
https://doi.org/10.1038/s41598-023-38377-2
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 8

Abstract

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Abstract The effect of the combination of atezolizumab and bevacizumab (Atez/Bev) for hepatocellular carcinoma (HCC) on pulmonary arterial hypertension (PAH) is unknown. Estimation of PAH by using computed tomography (CT) has recently been proposed. Thus, we aimed to estimate the effect of Atez/Bev on PAH using CT. Altogether, 113 patients who received Atez/Bev for HCC were enrolled. Probable PAH was defined as the diameter of the main pulmonary artery (mPA-D) ≥ 33 mm, whereas suspicious PAH was defined as mPA-D ≥ 29 mm or mPA-D/the diameter of the ascending aorta (aAo-D) ≥ 1.0. Before treatment, probable/suspicious PAH were diagnosed in 7 (6.7%)/22 (21.0%) patients, respectively. mPA-D and mPA-D/aAo-D significantly increased after induction of Atez/Bev. The increment of mPA-D was correlated with the occurrence of post-treatment respiratory/heart failure. In analysis of 55 patients who underwent CT at 3 months after the last dose of Atez/Bev, mPA-D and mPA-D/aAo-D significantly decreased. However, in the group with continuous treatment of other molecular-targeted drugs after Atez/Bev, mPA-D and mPA-D/aAo-D showed no significant change. In conclusion, PAH may not be a rare complication in patients with HCC and should be managed carefully because of the possible negative effect of Atez/Bev on PAH.