Hyperprogressive disease during atezolizumab plus bevacizumab treatment in patients with advanced hepatocellular carcinoma from Japanese real-world practice

• Published in: BMC gastroenterology 2023-03, Vol.23 (1), p.101-101, Article 101
• Main Authors: Yumita, Sae, Ogasawara, Sadahisa, Nakagawa, Miyuki, Maruta, Susumu, Okubo, Tomomi, Itokawa, Norio, Iino, Yotaro, Obu, Masamichi, Haga, Yuki, Seki, Atsuyoshi, Kogure, Tadayoshi, Ishino, Takamasa, Ogawa, Keita, Fujiwara, Kisako, Iwanaga, Terunao, Fujita, Naoto, Sakuma, Takafumi, Kojima, Ryuta, Kanzaki, Hiroaki, Koroki, Keisuke, Inoue, Masanori, Kobayashi, Kazufumi, Kiyono, Soichiro, Nakamura, Masato, Kanogawa, Naoya, Saito, Tomoko, Kondo, Takayuki, Nakagawa, Ryo, Nakamoto, Shingo, Muroyama, Ryosuke, Chiba, Tetsuhiro, Itobayashi, Ei, Atsukawa, Masanori, Koma, Yoshihiro, Azemoto, Ryosaku, Ito, Kenji, Mizumoto, Hideaki, Kato, Jun, Kato, Naoya
• Format: Article
• Language: English
• Subjects: Analysis; Apoptosis; Atezolizumab and bevacizumab; Bevacizumab; Bevacizumab - therapeutic use; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - pathology; Clinical deterioration; Development and progression; Disease Progression; Drug therapy; Drug therapy, Combination; East Asian People; Gastroenterology; Growth rate; Hepatitis; Hepatocellular carcinoma; Hepatoma; Humans; Hyperprogressive disease; Immune checkpoint inhibitors; Immunotherapy; Liver cancer; Liver Neoplasms - drug therapy; Liver Neoplasms - pathology; Magnetic resonance imaging; Medical prognosis; Medical records; Neutrophils; Patient outcomes; Patients; Retrospective Studies; Tumors; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-023-02731-5

Hyperprogressive disease (HPD) is a phenomenon with greatly accelerated tumor growth and clinical deterioration rates compared to pre-therapy, in patients treated with immune checkpoint inhibitors (ICI). The aim of this study is to clarify the reality of HPD in patients with advanced hepatocellular carcinoma (HCC) who were treated with atezolizumab plus bevacizumab (Atez/Bev) using tumor dynamics. Medical records of consecutive patients with advanced HCC who were treated with Atez/Bev were retrospectively reviewed. HPD was defined as a more than two- or fourfold increase in tumor growth rate (TGR) or tumor growth kinetics rate (TGK ) before and after treatment. Overall survival (OS) and baseline characteristics with or without HPD were analyzed. A total of 85 patients were included in the analysis. When HPD was defined as a twofold of TGR or TGK , 8 patients (8/85, 9.4%) had HPD and 11 had PD without HPD. A total of 5 patients (5/85, 5.9%) were diagnosed with HPD and 14 with PD without HPD when HPD was defined as a fourfold of TGR or TGK . No significant difference was observed in the baseline characteristics between HPD and non-HPD. The prevalence of HPD in patients with advanced HCC treated with Atez/Bev was lower than those treated with nivolumab monotherapy. The HPD mechanism in ICI combined with antibodies targeting vascular endothelial growth factor (VEGF) remains to be elucidated.