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Adverse Events as Potential Predictive Factors of Activity in Patients with Advanced HCC Treated with Atezolizumab Plus Bevacizumab.


ABSTRACT:

Background

In the context of patients with hepatocellular carcinoma (HCC) treated with systemic therapy, the correlation between the appearance of adverse events (AEs) and reported efficacy outcomes is well-known and widely investigated. From other pathological settings, we are aware of the prognostic and predictive value of the occurrence of immune-related AEs in patients treated with immune-checkpoint inhibitors.

Objective

This retrospective multicenter real-world study aims to investigate the potential prognostic value of AEs in patients with HCC treated with atezolizumab plus bevacizumab in the first-line setting.

Patients and methods

The study population consisted of 823 patients from five countries (Italy, Germany, Portugal, Japan, and the Republic of Korea).

Results

Of the patients, 73.3% presented at least one AE during the study period. The most common AEs were proteinuria (29.6%), arterial hypertension (27.2%), and fatigue (26.0%). In all, 17.3% of the AEs were grade (G) 3. One death due to bleeding was reported. The multivariate analysis confirmed the appearance of decreased appetite G < 2 [versus G ≥ 2; hazard ratio (HR) 0.60; 95% confidence interval (CI) 0.13-0.90; p < 0.01] and immunotoxicity G < 2 (versus G ≥ 2; HR: 0.70; 95% CI 0.24-0.99; p = 0.04) as independent prognostic factors for overall survival, and the appearance of decreased appetite G < 2 (versus G ≥ 2; HR: 0.73; 95% CI 0.43-0.95; p = 0.01), diarrhea (yes versus no; HR: 0.57, 95% CI 0.38-0.85; p = 0.01), fatigue (yes versus no; HR: 0.82, 95% CI 0.65-0.95; p < 0.01), arterial hypertension G < 2 (versus G ≥ 2; HR: 0.68, 95% CI 0.52-0.87; p < 0.01), and proteinuria (yes versus no; HR: 0.79, 95% CI 0.64-0.98; p = 0.03) as independent prognostic factors for progression-free survival.

Conclusions

As demonstrated for other therapies, there is also a correlation between the occurrence of AEs and outcomes for patients with HCC for the combination of atezolizumab plus bevacizumab.

SUBMITTER: Persano M 

PROVIDER: S-EPMC11230956 | biostudies-literature | 2024 Jul

REPOSITORIES: biostudies-literature

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Adverse Events as Potential Predictive Factors of Activity in Patients with Advanced HCC Treated with Atezolizumab Plus Bevacizumab.

Persano Mara M   Rimini Margherita M   Tada Toshifumi T   Suda Goki G   Shimose Shigeo S   Kudo Masatoshi M   Rossari Federico F   Yoo Changhoon C   Cheon Jaekyung J   Finkelmeier Fabian F   Lim Ho Yeong HY   Presa José J   Masi Gianluca G   Bergamo Francesca F   Amadeo Elisabeth E   Vitiello Francesco F   Kumada Takashi T   Sakamoto Naoya N   Iwamoto Hideki H   Aoki Tomoko T   Chon Hong Jae HJ   Himmelsbach Vera V   Iavarone Massimo Alberto MA   Cabibbo Giuseppe G   Montes Margarida M   Foschi Francesco Giuseppe FG   Vivaldi Caterina C   Soldà Caterina C   Sho Takuya T   Niizeki Takashi T   Nishida Naoshi N   Steup Christoph C   Bruccoleri Mariangela M   Hirooka Masashi M   Kariyama Kazuya K   Tani Joji J   Atsukawa Masanori M   Takaguchi Koichi K   Itobayashi Ei E   Fukunishi Shinya S   Tsuji Kunihiko K   Ishikawa Toru T   Tajiri Kazuto K   Ochi Hironori H   Yasuda Satoshi S   Toyoda Hidenori H   Ogawa Chikara C   Nishimura Takashi T   Hatanaka Takeshi T   Kakizaki Satoru S   Shimada Noritomo N   Kawata Kazuhito K   Hiraoka Atsushi A   Tada Fujimasa F   Ohama Hideko H   Nouso Kazuhiro K   Morishita Asahiro A   Tsutsui Akemi A   Nagano Takuya T   Itokawa Norio N   Okubo Tomomi T   Imai Michitaka M   Kosaka Hisashi H   Naganuma Atsushi A   Koizumi Yohei Y   Nakamura Shinichiro S   Kaibori Masaki M   Iijima Hiroko H   Hiasa Yoichi Y   Foti Silvia S   Camera Silvia S   Piscaglia Fabio F   Scartozzi Mario M   Cascinu Stefano S   Casadei-Gardini Andrea A  

Targeted oncology 20240430 4


<h4>Background</h4>In the context of patients with hepatocellular carcinoma (HCC) treated with systemic therapy, the correlation between the appearance of adverse events (AEs) and reported efficacy outcomes is well-known and widely investigated. From other pathological settings, we are aware of the prognostic and predictive value of the occurrence of immune-related AEs in patients treated with immune-checkpoint inhibitors.<h4>Objective</h4>This retrospective multicenter real-world study aims to  ...[more]

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