|
1
|
Kuzuya T, Kawabe N, Muto H, Tachi Y, Ukai T, Wada Y, Komura G, Nakano T, Tanaka H, Nakaoka K, Ohno E, Funasaka K, Nagasaka M, Miyahara R, Hirooka Y. Characteristics and Prognosis of Patients with Advanced Hepatocellular Carcinoma Treated with Atezolizumab/Bevacizumab Combination Therapy Who Achieved Complete Response. Curr Oncol 2024; 31:6218-6231. [PMID: 39451767 PMCID: PMC11506828 DOI: 10.3390/curroncol31100463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2024] [Revised: 10/06/2024] [Accepted: 10/15/2024] [Indexed: 10/26/2024] Open
Abstract
AIM To investigate the characteristics and prognosis of patients with advanced hepatocellular carcinoma (HCC) treated with atezolizumab and bevacizumab (Atz/Bev) who achieved a complete response (CR) according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). METHODS A total of 120 patients with Eastern Cooperative Oncology Group performance status (PS) 0 or 1 and Child-Pugh A at the start of Atz/Bev treatment were included. Barcelona Clinic Liver Cancer stage C was recorded in 59 patients. RESULTS The CR rate with Atz/Bev alone was 15.0%. The median time to CR was 3.4 months, and the median duration of CR was 15.6 months. A significant factor associated with achieving CR with Atz/Bev alone was an AFP ratio of 0.34 or less at 3 weeks. Adding transarterial chemoembolization (TACE) in the six patients who achieved a partial response increased the overall CR rate to 20%. Among the 24 patients who achieved CR, the median progression-free survival was 19.3 months, the median overall survival was not reached, and 14 patients (58.3%) were able to discontinue Atz/Bev and achieve a drug-free status. Twelve of these patients developed progressive disease (PD), but eleven successfully received post-PD treatments and responded well. CONCLUSIONS Achieving CR by mRECIST using Atz/Bev alone or with additional TACE can be expected to offer an extremely favorable prognosis.
Collapse
Affiliation(s)
- Teiji Kuzuya
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
| | - Naoto Kawabe
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
| | - Hisanori Muto
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
- Department of Gastroenterology and Hepatology, Fujita Health University Bantane Hospital, Nagoya 454-8509, Japan
| | - Yoshihiko Tachi
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
- Department of Gastroenterology, Fujita Health University Okazaki Medical Center, Okazaki 444-0827, Japan
| | - Takeshi Ukai
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
| | - Yuryo Wada
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
| | - Gakushi Komura
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
| | - Takuji Nakano
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
| | - Hiroyuki Tanaka
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
| | - Kazunori Nakaoka
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
| | - Eizaburo Ohno
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
| | - Kohei Funasaka
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
| | - Mitsuo Nagasaka
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
| | - Ryoji Miyahara
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
| | - Yoshiki Hirooka
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake 470-1192, Japan; (N.K.); (H.M.); (Y.T.); (T.U.); (Y.W.); (G.K.); (T.N.); (H.T.); (K.N.); (E.O.); (K.F.); (M.N.); (R.M.); (Y.H.)
| |
Collapse
|
|
2
|
Moriguchi M, Kataoka S, Itoh Y. Evolution of Systemic Treatment for Hepatocellular Carcinoma: Changing Treatment Strategies and Concepts. Cancers (Basel) 2024; 16:2387. [PMID: 39001448 PMCID: PMC11240810 DOI: 10.3390/cancers16132387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/16/2024] Open
Abstract
Systemic therapy for hepatocellular carcinoma (HCC) has undergone substantial advancements. With the advent of atezolizumab plus bevacizumab (ATZ/BEV) combination therapy, followed by durvalumab plus tremelimumab, the era of immunotherapy for HCC has commenced. The emergence of systemic treatment with high response rates has led to improvements in overall survival while enabling conversion to radical surgical resection in some patients with HCC. In patients with intermediate-stage HCC, new treatment strategies combining systemic treatment and transcatheter arterial chemoembolization (TACE) are under development in clinical trials. Moreover, the addition of local therapies, such as TACE, to systemic treatment according to the treatment effect could achieve a certain percentage of complete response. In the IMbrave050 trial, the efficacy of ATZ/BEV combination therapy was validated in patients predicted to have a high risk of recurrence, especially in those who had undergone radical surgery or radiofrequency ablation for HCC. Therefore, systemic treatment for HCC is entering a new phase for all disease stages. The objective of this review is to organize the current position of systemic therapy for each HCC stage and discuss the development of new treatment methods and strategies, with a focus on regimens incorporating immune checkpoint inhibitors, along with future prospects.
Collapse
Affiliation(s)
- Michihisa Moriguchi
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan; (S.K.); (Y.I.)
| | | | | |
Collapse
|