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Research ArticleClinical Studies

Current Role of Atezolizumab Plus Bevacizumab Therapy in the Sequential Treatment of Unresectable Hepatocellular Carcinoma

SHOHEI KOMATSU, YOSHIHIKO YANO, YOSHIMI FUJISHIMA, JUN ISHIDA, MASAHIRO KIDO, KAORI KURAMITSU, ATSUSHI YAMAMOTO, TADAHIRO GOTO, HIROAKI YANAGIMOTO, HIROCHIKA TOYAMA, YOSHIHIDE UEDA, YUZO KODAMA and TAKUMI FUKUMOTO
Anticancer Research March 2022, 42 (3) 1403-1412; DOI: https://doi.org/10.21873/anticanres.15610
SHOHEI KOMATSU
1Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;
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  • For correspondence: komasho8@med.kobe-u.ac.jp
YOSHIHIKO YANO
2Department of Internal Medicine, Division of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Japan;
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YOSHIMI FUJISHIMA
3Division of Medical Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan;
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JUN ISHIDA
4Division of Radiology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
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MASAHIRO KIDO
1Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;
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KAORI KURAMITSU
1Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;
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ATSUSHI YAMAMOTO
2Department of Internal Medicine, Division of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Japan;
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TADAHIRO GOTO
1Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;
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HIROAKI YANAGIMOTO
1Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;
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HIROCHIKA TOYAMA
1Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;
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YOSHIHIDE UEDA
2Department of Internal Medicine, Division of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Japan;
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YUZO KODAMA
2Department of Internal Medicine, Division of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Japan;
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TAKUMI FUKUMOTO
1Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;
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Abstract

Background/Aim: Atezolizumab plus bevacizumab therapy is the new standard treatment option for advanced hepatocellular carcinoma (HCC). The clinical details and sequential course after atezolizumab plus bevacizumab therapy remain to be determined. Patients and Methods: Thirty-four consecutive patients who received atezolizumab plus bevacizumab therapy were evaluated. Their clinical outcomes were assessed according to liver function classified by modified albumin-bilirubin (ALBI) grade 1 and 2a (1/2a) versus 2b and treatment line (first-line versus second- or later-line). Furthermore, the treatment sequence after atezolizumab plus bevacizumab therapy was also assessed. Results: The objective response and disease control rates were 15.6% and 93.8%, respectively. The median proportions of ALBI scores at 1, 2, and 3 months relative to the baseline scores were 0.94, 0.97, and 0.93, respectively. The median proportions of α-fetoprotein (AFP) scores at 1, 2, and 3 months relative to the baseline scores were 0.98, 1.12, and 1.83, respectively. There were no significant differences in the changes in the proportions of AFP and ALBI scores according to both liver function and treatment line. Twelve patients were administered lenvatinib treatment after the failure of atezolizumab plus bevacizumab therapy. The proportions of AFP and ALBI scores at 1 month relative to the baseline scores were 0.55 and 0.81, respectively. Conclusion: Atezolizumab plus bevacizumab therapy can be effective for advanced HCC irrespective of the patients’ liver function and treatment line. Lenvatinib administration after atezolizumab plus bevacizumab therapy can be effective, although special attention should be paid to the deterioration of liver function.

Key Words:
  • Hepatocellular carcinoma
  • atezolizumab plus bevacizumab
  • albumin-bilirubin grade
  • lenvatinib
  • treatment sequence
  • Received January 14, 2022.
  • Revision received February 1, 2022.
  • Accepted February 4, 2022.
  • Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 42 (3)
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Current Role of Atezolizumab Plus Bevacizumab Therapy in the Sequential Treatment of Unresectable Hepatocellular Carcinoma
SHOHEI KOMATSU, YOSHIHIKO YANO, YOSHIMI FUJISHIMA, JUN ISHIDA, MASAHIRO KIDO, KAORI KURAMITSU, ATSUSHI YAMAMOTO, TADAHIRO GOTO, HIROAKI YANAGIMOTO, HIROCHIKA TOYAMA, YOSHIHIDE UEDA, YUZO KODAMA, TAKUMI FUKUMOTO
Anticancer Research Mar 2022, 42 (3) 1403-1412; DOI: 10.21873/anticanres.15610

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Current Role of Atezolizumab Plus Bevacizumab Therapy in the Sequential Treatment of Unresectable Hepatocellular Carcinoma
SHOHEI KOMATSU, YOSHIHIKO YANO, YOSHIMI FUJISHIMA, JUN ISHIDA, MASAHIRO KIDO, KAORI KURAMITSU, ATSUSHI YAMAMOTO, TADAHIRO GOTO, HIROAKI YANAGIMOTO, HIROCHIKA TOYAMA, YOSHIHIDE UEDA, YUZO KODAMA, TAKUMI FUKUMOTO
Anticancer Research Mar 2022, 42 (3) 1403-1412; DOI: 10.21873/anticanres.15610
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Keywords

  • Hepatocellular carcinoma
  • atezolizumab plus bevacizumab
  • albumin-bilirubin grade
  • Lenvatinib
  • treatment sequence
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