Tumor steatosis and glutamine synthetase expression in patients with advanced hepatocellular carcinoma receiving atezolizumab plus bevacizumab therapy

• DOI: 10.1111/hepr.13933
• Publication Date: 2023-06-10T06:29:20Z
• Authors: Yutaka Kurebayashi; Hanako Tsujikawa; Katsutoshi Sugimoto; Daisuke Yunaiyama; Yoichi Araki; Kazuhiro Saito; Hiroshi Takahashi; Tatsuya Kakegawa; Takuya Wada; Yusuke Tomita; Masakazu Abe; Yu Yoshimasu; Hirohito Takeuchi; Taiki Hirata; Kentaro Sakamaki; Kazuhiro Kakimi; Toshitaka Nagao; Takao Itoi; Michiie Sakamoto
• Keywords: Atezolizumab; Steatosis

The anti-programmed death-ligand 1 antibody atezolizumab and vascular endothelial growth factor-neutralizing bevacizumab in combination (Atezo + Bev) have become the first-line therapy advanced hepatocellular carcinoma (HCC). Distinct types of tumor immune microenvironment (TIME) their associations with specific molecular subclasses driver gene mutations been identified HCC; however, these insights are mainly based on surgically resected early-stage tumors. current study aimed to reveal biology TIME HCC significance predicting clinical outcomes Atezo Bev therapy.Thirty-three patients who were scheduled for treatment included this study. Pretreatment biopsy, pre- posttreatment diffusion-weighted magnetic resonance imaging (MRI) nine b values (0-1500 s/mm2 ), other clinicopathologic factors analyzed.Compared resectable HCC, was characterized by higher proliferative activity, a frequency Wnt/β-catenin-activated lower lymphocytic infiltration. Prognostically, two metabolism-related factors, histopathologically determined steatosis and/or glutamine synthetase (GS) expression, MRI-determined steatosis, most significant prognostic indicators progression-free survival (PFS) overall after therapy. Furthermore, changes true diffusion coefficients MRI, which might reflect treatment, significantly associated better PFS.The strikingly different compared those HCC. Two pathologically GS found be