Therapeutic efficacy of atezolizumab plus bevacizumab treatment for unresectable hepatocellular carcinoma in patients with Child‐Pugh class A or B liver function in real‐world clinical practice

• DOI: 10.1111/hepr.13797
• Publication Date: 2022-05-28T15:38:58Z
• Authors: Takaaki Tanaka; 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; Takeshi Hatanaka; Satoru Kakizaki; Noritomo Shimada; Kazuhito Kawata; Atsushi Naganuma; Hisashi Kosaka; Hideko Ohama; Kazuhiro Nouso; Asahiro Morishita; Akemi Tsutsui; Takuya Nagano; Norio Itokawa; Tomomi Okubo; Taeang Arai; Michitaka Imai; Yohei Koizumi; Shinichiro Nakamura; Kouji Joko; Hiroko Iijima; Masaki Kaibori; Yoichi Hiasa; Masatoshi Kudo; Takashi Kumada
• Keywords: Liver function; Atezolizumab

Atezolizumab plus bevacizumab (Atez/Bev) treatment is recommended for unresechepatocellular carcinoma (u-HCC) patients classified as Child-Pugh A (CP-A). This study aimed to elucidate the prognosis of treated with Atez/Bev, especially CP-A and -B cases.From September 2020 March 2022, 457 u-HCC Atez/Bev were enrolled (median age 74 years, male:female = 368:89, CP-A:CP-B 427:30, score [CPS] 5:6:7:8:9 271:156:21:8:1). Therapeutic response was evaluated using RECIST ver.1.1. Clinical features retrospectively evaluated.There no significant differences between in regard best (CR:PR:SD:PD 16:91:194:81 vs. 0:7:13:8, p 0.739; objective rate/disease control rate 28.0%/78.8% 25.0%/71.4%). Analysis performed inverse probability weighting adjustments clinical factors other than those related hepatic reserve function a value < 0.10 comparisons showed that progression-free survival (PFS) cases better (6-/12-/18-month: 58.2%/36.1%/27.8% 49.6%/8.7%/non-estimable [NE], 0.001), overall (OS) 89.9%/71.7%/51.4% versus 63.6%/18.4%/NE; 0.001). Median PFS (mPFS) median OS (mOS) CPS-5 9.5 months/NE, 5.1/14.0 months CPS-6 (both Furthermore, modified albumin-bilirubin grade (mALBI)-1/2a/2b, mPFS 9.4/8.5/5.3 (p 0.001) mOS NE/17.8/13.4 0.001).Better function, such mALBI 1 or 2a are thought indicate condition obtaining sufficient patients, whereas CP-B who mainly shown an 2b 3, might have less therapeutic efficacy.