Comparison of prognostic impact of atezolizumab plus bevacizumab versus lenvatinib in patients with intermediate-stage hepatocellular carcinoma
Corresponding Author
Toshifumi Tada
Department of Gastroenterology, Japanese Red Cross Society Himeji Hospital, Himeji, Hyogo, Japan
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Yahaba-cho, Iwate, Japan
Correspondence
Toshifumi Tada, Department of Gastroenterology, Japanese Red Cross Society Himeji Hospital, Himeji, Hyogo, Japan, 1-12-1 Shimoteno, Himeji, Hyogo, Japan.
Email: [email protected]
Handling Editor: Alejandro Forner
Search for more papers by this authorTakashi Kumada
Department of Nursing, Gifu Kyoritsu University, Ogaki, Gifu, Japan
Search for more papers by this authorAtsushi Hiraoka
Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan
Search for more papers by this authorMasashi Hirooka
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
Search for more papers by this authorKazuya Kariyama
Department of Gastroenterology, Okayama City Hospital, Okayama, Okayama, Japan
Search for more papers by this authorJoji Tani
Department of Gastroenterology and Hepatology, Kagawa University, Miki-cho, Kagawa, Japan
Search for more papers by this authorMasanori Atsukawa
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
Search for more papers by this authorKoichi Takaguchi
Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan
Search for more papers by this authorEi Itobayashi
Department of Gastroenterology, Asahi General Hospital, Asahi, Chiba, Japan
Search for more papers by this authorShinya Fukunishi
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
Department of Gastroenterology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
Search for more papers by this authorKunihiko Tsuji
Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
Search for more papers by this authorToru Ishikawa
Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Niigata, Japan
Search for more papers by this authorKazuto Tajiri
Department of Gastroenterology, Toyama University Hospital, Toyama, Toyama, Japan
Search for more papers by this authorHironori Ochi
Hepato-biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Ehime, Japan
Search for more papers by this authorSatoshi Yasuda
Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan
Search for more papers by this authorHidenori Toyoda
Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan
Search for more papers by this authorChikara Ogawa
Department of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Kagawa, Japan
Search for more papers by this authorTakashi Nishimura
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
Search for more papers by this authorTakeshi Hatanaka
Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Gunma, Japan
Search for more papers by this authorSatoru Kakizaki
Department of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Gunma, Japan
Search for more papers by this authorNoritomo Shimada
Division of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Chiba, Japan
Search for more papers by this authorKazuhito Kawata
Department of Hepatology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
Search for more papers by this authorFujimasa Tada
Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan
Search for more papers by this authorHideko Ohama
Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan
Search for more papers by this authorKazuhiro Nouso
Department of Gastroenterology, Okayama City Hospital, Okayama, Okayama, Japan
Search for more papers by this authorAsahiro Morishita
Department of Gastroenterology and Hepatology, Kagawa University, Miki-cho, Kagawa, Japan
Search for more papers by this authorAkemi Tsutsui
Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan
Search for more papers by this authorTakuya Nagano
Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan
Search for more papers by this authorNorio Itokawa
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
Search for more papers by this authorTomomi Okubo
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
Search for more papers by this authorTaeang Arai
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
Search for more papers by this authorMichitaka Imai
Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Niigata, Japan
Search for more papers by this authorHisashi Kosaka
Department of Surgery, Kansai Medical University, Hirakata, Osaka, Japan
Search for more papers by this authorAtsushi Naganuma
Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Gunma, Japan
Search for more papers by this authorTomomitsu Matono
Department of Internal Medicine, Himeji St. Mary's Hospital, Himeji, Hyogo, Japan
Search for more papers by this authorTomoko Aoki
Department of Gastroenterology and Hepatology, Kindai University, Sayama, Osaka, Japan
Search for more papers by this authorHidekatsu Kuroda
Department of Gastroenterology, Hanwa Memorial Hospital, Osaka, Osaka, Japan
Search for more papers by this authorYutaka Yata
Department of Gastroenterology, Hanwa Memorial Hospital, Osaka, Osaka, Japan
Search for more papers by this authorYohei Koizumi
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
Search for more papers by this authorShinichiro Nakamura
Department of Gastroenterology, Japanese Red Cross Society Himeji Hospital, Himeji, Hyogo, Japan
Search for more papers by this authorMasaki Kaibori
Department of Surgery, Kansai Medical University, Hirakata, Osaka, Japan
Search for more papers by this authorHiroko Iijima
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
Search for more papers by this authorYoichi Hiasa
Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan
Search for more papers by this authorMasatoshi Kudo
Department of Gastroenterology and Hepatology, Kindai University, Sayama, Osaka, Japan
Search for more papers by this authorthe Real-life Practice Experts for HCC (RELPEC) Study Group and the Hepatocellular Carcinoma Experts from 48 clinics in Japan (HCC 48) Group
Search for more papers by this authorCorresponding Author
Toshifumi Tada
Department of Gastroenterology, Japanese Red Cross Society Himeji Hospital, Himeji, Hyogo, Japan
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Yahaba-cho, Iwate, Japan
Correspondence
Toshifumi Tada, Department of Gastroenterology, Japanese Red Cross Society Himeji Hospital, Himeji, Hyogo, Japan, 1-12-1 Shimoteno, Himeji, Hyogo, Japan.
Email: [email protected]
Handling Editor: Alejandro Forner
Search for more papers by this authorTakashi Kumada
Department of Nursing, Gifu Kyoritsu University, Ogaki, Gifu, Japan
Search for more papers by this authorAtsushi Hiraoka
Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan
Search for more papers by this authorMasashi Hirooka
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
Search for more papers by this authorKazuya Kariyama
Department of Gastroenterology, Okayama City Hospital, Okayama, Okayama, Japan
Search for more papers by this authorJoji Tani
Department of Gastroenterology and Hepatology, Kagawa University, Miki-cho, Kagawa, Japan
Search for more papers by this authorMasanori Atsukawa
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
Search for more papers by this authorKoichi Takaguchi
Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan
Search for more papers by this authorEi Itobayashi
Department of Gastroenterology, Asahi General Hospital, Asahi, Chiba, Japan
Search for more papers by this authorShinya Fukunishi
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
Department of Gastroenterology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
Search for more papers by this authorKunihiko Tsuji
Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
Search for more papers by this authorToru Ishikawa
Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Niigata, Japan
Search for more papers by this authorKazuto Tajiri
Department of Gastroenterology, Toyama University Hospital, Toyama, Toyama, Japan
Search for more papers by this authorHironori Ochi
Hepato-biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Ehime, Japan
Search for more papers by this authorSatoshi Yasuda
Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan
Search for more papers by this authorHidenori Toyoda
Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan
Search for more papers by this authorChikara Ogawa
Department of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Kagawa, Japan
Search for more papers by this authorTakashi Nishimura
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
Search for more papers by this authorTakeshi Hatanaka
Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Gunma, Japan
Search for more papers by this authorSatoru Kakizaki
Department of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Gunma, Japan
Search for more papers by this authorNoritomo Shimada
Division of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Chiba, Japan
Search for more papers by this authorKazuhito Kawata
Department of Hepatology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
Search for more papers by this authorFujimasa Tada
Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan
Search for more papers by this authorHideko Ohama
Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan
Search for more papers by this authorKazuhiro Nouso
Department of Gastroenterology, Okayama City Hospital, Okayama, Okayama, Japan
Search for more papers by this authorAsahiro Morishita
Department of Gastroenterology and Hepatology, Kagawa University, Miki-cho, Kagawa, Japan
Search for more papers by this authorAkemi Tsutsui
Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan
Search for more papers by this authorTakuya Nagano
Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan
Search for more papers by this authorNorio Itokawa
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
Search for more papers by this authorTomomi Okubo
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
Search for more papers by this authorTaeang Arai
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
Search for more papers by this authorMichitaka Imai
Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Niigata, Japan
Search for more papers by this authorHisashi Kosaka
Department of Surgery, Kansai Medical University, Hirakata, Osaka, Japan
Search for more papers by this authorAtsushi Naganuma
Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Gunma, Japan
Search for more papers by this authorTomomitsu Matono
Department of Internal Medicine, Himeji St. Mary's Hospital, Himeji, Hyogo, Japan
Search for more papers by this authorTomoko Aoki
Department of Gastroenterology and Hepatology, Kindai University, Sayama, Osaka, Japan
Search for more papers by this authorHidekatsu Kuroda
Department of Gastroenterology, Hanwa Memorial Hospital, Osaka, Osaka, Japan
Search for more papers by this authorYutaka Yata
Department of Gastroenterology, Hanwa Memorial Hospital, Osaka, Osaka, Japan
Search for more papers by this authorYohei Koizumi
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
Search for more papers by this authorShinichiro Nakamura
Department of Gastroenterology, Japanese Red Cross Society Himeji Hospital, Himeji, Hyogo, Japan
Search for more papers by this authorMasaki Kaibori
Department of Surgery, Kansai Medical University, Hirakata, Osaka, Japan
Search for more papers by this authorHiroko Iijima
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
Search for more papers by this authorYoichi Hiasa
Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan
Search for more papers by this authorMasatoshi Kudo
Department of Gastroenterology and Hepatology, Kindai University, Sayama, Osaka, Japan
Search for more papers by this authorthe Real-life Practice Experts for HCC (RELPEC) Study Group and the Hepatocellular Carcinoma Experts from 48 clinics in Japan (HCC 48) Group
Search for more papers by this authorAbstract
Background & Aims
The study goal was to compare the outcomes of patients with intermediate-stage (Barcelona Clinic Liver Cancer [BCLC]-B) hepatocellular carcinoma (HCC) who received atezolizumab plus bevacizumab (Atezo/Bev) or lenvatinib (LEN) as first-line systemic therapy.
Methods
A total of 358 patients with BCLC-B HCC treated with Atezo/Bev (n = 177) or LEN (n = 181) as first-line systemic therapy were included.
Results
The median progression-free survival (PFS) times in the Atezo/Bev and LEN groups were 10.8 months (95% confidence interval [CI], 7.8–12.6) and 7.3 months (95% CI, 6.3–8.5), respectively (p = .019). In the propensity score-matched cohort, the median PFS times in the Atezo/Bev (n = 151) and LEN (n = 151) groups were 10.2 months (95% CI, 7.0–12.3) and 6.9 months (95% CI, 5.9–8.1), respectively (p = .020). Restricted mean survival times of PFS were significantly higher in the Atezo/Bev group than in the LEN group at landmarks of 12 and 18 months (p = .031 and .012, respectively). In a subgroup analysis of patients with HCC beyond the up-to-seven criteria, the median PFS times in the Atezo/Bev (n = 134) and LEN (n = 117) groups were 10.5 months (95% CI, 7.0–11.8) and 6.3 months (95% CI, 5.5–7.3), respectively (p = .044).
Conclusions
The use of Atezo/Bev as first-line systemic therapy in patients with BCLC-B HCC is expected to result in good PFS.
CONFLICT OF INTEREST STATEMENT
Toshifumi Tada: lecture fees from AbbVie, Eisai, and Chugai. Atsushi Hiraoka: lecture fees from Eisai, Bayer, Eli Lilly, and Otsuka. Takashi Kumada: lecture fees from Eisai. Hidenori Toyoda: lecture fees from AbbVie, Eisai, Gilead, Terumo, and Bayer. Takeshi Hatanaka: lecture fees from Eisai. Masatoshi Kudo: advisory role at Eisai, Ono, MSD, Bristol-Myers Squibb, and Roche; lecture fees from Eisai, Bayer, MSD, Bristol-Myers Squibb, Eli Lilly, and EA Pharma; and research funding from Gilead Sciences, Taiho, Sumitomo Dainippon Pharma, Takeda, Otsuka, EA Pharma, AbbVie, and Eisai. None of the other authors have potential conflicts of interest to declare.
Open Research
DATA AVAILABILITY STATEMENT
The datasets are available from the corresponding author upon reasonable request.
Supporting Information
| Filename | Description |
|---|---|
| liv15753-sup-0001-TableS1.pdfPDF document, 91.2 KB |
Table S1 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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