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      Comparison between Atezolizumab Plus Bevacizumab and Lenvatinib for Hepatocellular Carcinoma in Patients with Child-Pugh Class B in Real-World Clinical Settings

      research-article
      a , a , b , c , d , e , f , g , h , i , j , k , l , m , n , n , o , p , q , r , s , t , u , v , w , x , y , a , d , e , g , g , f , f , f , k , c , b , p , v , c , y , z
      Oncology
      S. Karger AG
      Hepatocellular carcinoma, Atezolizumab Plus bevacizumab, Lenvatinib, Child-Pugh B

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          Abstract

          Introduction: Systemic treatment is generally recommended for Child-Pugh (CP) A status patients with an unresectable hepatocellular carcinoma (uHCC). This study aimed to elucidate differences regarding therapeutic efficacy between lenvatinib (LEN), a multi-molecular target agent, and atezolizumab plus bevacizumab (Atez/Bev), a newly developed immune-combined therapeutic regimen for CP-B patients affected by uHCC. Methods: From April 2018 to July 2022, 128 patients with uHCC treated with Atez/Bev ( n = 29) or LEN ( n = 99) as the initial systemic treatment were enrolled (median age 71 years; males 97; CP score 7:8:9 = 94:28:6; median albumin-bilirubin score −1.71). Therapeutic response was evaluated using RECIST, version 1.1. Clinical features and prognosis were retrospectively examined. Results: There were no significant differences between the Atez/Bev and LEN groups in regard to best response (CR:PR:SD:PD = 0:5:12:7 vs. 5:22:25:20, p = 0.415), progression-free survival (PFS) (median 5.0 [95% CI: 2.4–7] vs. 5.5 [95% CI: 3.4–7.9] months, p = 0.332), or overall survival (OS) (5.8 [95% CI: 4.3–11] vs. 8.8 [95% CI: 6.1–12.9] months, p = 0.178). Adverse events (any grade/≥ grade 3) were observed in 72.4%/17.2% ( n = 21/5) of patients treated with Atez/Bev and 78.8%/25.3% ( n = 78/25) of those treated with LEN ( p = 0.46/0.46). Discussion: This retrospective study found no significant differences regarding PFS or OS between CP-B patients given Atez/Bev or LEN as initial systemic treatment for uHCC.

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          Author and article information

          Journal
          OCL
          Oncology
          10.1159/issn.0030-2414
          Oncology
          Oncology
          S. Karger AG
          0030-2414
          1423-0232
          2023
          September 2023
          08 August 2023
          : 101
          : 9
          : 542-552
          Affiliations
          [_a] aGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
          [_b] bDepartment of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan
          [_c] cDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
          [_d] dDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan
          [_e] eDepartment of Gastroenterology and Hepatology, Kagawa University, Takamatsu, Japan
          [_f] fDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
          [_g] gDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
          [_h] hDepartment of Gastroenterology, Asahi General Hospital, Asahi, Japan
          [_i] iDepartment of Gastroenterology, Osaka Medical and Pharmaceutical University, Osaka, Japan
          [_j] jCenter of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
          [_k] kDepartment of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan
          [_l] lDepartment of Gastroenterology, Toyama University Hospital, Toyama, Japan
          [_m] mHepato-biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Japan
          [_n] nDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
          [_o] oDepartment of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Japan
          [_p] pDepartment of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan
          [_q] qDepartment of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan
          [_r] rDepartment of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan
          [_s] sDivision of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Japan
          [_t] tHepatology Division, Department of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan
          [_u] uDepartment of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan
          [_v] vDepartment of Surgery, Kansai Medical University, Hirakata, Japan
          [_w] wDepartment of Hepatology, St. Mary’s Hospital, Himeji, Japan
          [_x] xDepartment of Gastroenterology, Tokushima Prefectural Central Hospital, Tokushima, Japan
          [_y] yDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
          [_z] zDepartment of Nursing, Gifu Kyoritsu University, Ogaki, Japan
          Author information
          https://orcid.org/0000-0002-0976-6761
          https://orcid.org/0000-0003-3996-7502
          https://orcid.org/0000-0001-8801-2505
          https://orcid.org/0000-0002-5470-9694
          https://orcid.org/0000-0002-1652-6168
          https://orcid.org/0000-0002-4534-6692
          https://orcid.org/0000-0002-5517-8303
          https://orcid.org/0000-0003-3656-285X
          https://orcid.org/0000-0003-0224-7093
          https://orcid.org/0000-0002-4986-8578
          https://orcid.org/0000-0003-0663-0102
          https://orcid.org/0000-0002-2926-9973
          https://orcid.org/0000-0002-2018-0008
          https://orcid.org/0000-0003-1244-4736
          https://orcid.org/0000-0001-6448-6036
          https://orcid.org/0000-0002-0577-3921
          https://orcid.org/0000-0003-2211-495X
          Article
          530028 Oncology 2023;101:542–552
          10.1159/000530028
          37552968
          117c0ec2-5b91-4bc7-b191-57707bee30b0
          © 2023 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

          History
          : 07 November 2022
          : 24 February 2023
          Page count
          Figures: 6, Tables: 2, Pages: 11
          Funding
          Authors conducted the study on their own. There is none to declare of receiving funding.
          Categories
          Clinical Study

          Medicine
          Lenvatinib,Atezolizumab Plus bevacizumab,Hepatocellular carcinoma,Child-Pugh B
          Medicine
          Lenvatinib, Atezolizumab Plus bevacizumab, Hepatocellular carcinoma, Child-Pugh B

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