Predictive factors for transition to conversion therapy in hepatocellular carcinoma using atezolizumab plus bevacizumab

Background To identify predictive factors associated with successful transition to conversion therapy following combination therapy with atezolizumab and bevacizumab in the treatment of unresectable hepatocellular carcinoma (HCC). Methods In total, 188 patients with HCC, who received atezolizumab pl...

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Bibliographic Details
Published in:Liver international 2024-06, Vol.44 (6), p.1456-1463
Main Authors: Kikuchi, Tatsuya, Takeuchi, Yasuto, Nouso, Kazuhiro, Kariyama, Kazuya, Kuwaki, Kenji, Toshimori, Junichi, Iwado, Shota, Moriya, Akio, Hagihara, Hiroaki, Takabatake, Hiroyuki, Tada, Toshifumi, Yasunaka, Tetsuya, Sakata, Masahiro, Sue, Masahiko, Miyake, Nozomi, Adachi, Takuya, Wada, Nozomu, Onishi, Hideki, Shiraha, Hidenori, Takaki, Akinobu, Otsuka, Motoyuki
Format: Article
Language:English
Subjects:
Ablation
alfa‐fetoprotein
atezolizumab
Barcelona clinic liver cancer stage
Bevacizumab
Cancer therapies
cancer‐free
Chemotherapy
child‐Pugh score
Combination therapy
conversion therapy
Hepatocellular carcinoma
Lesions
Liver cancer
Multivariate analysis
Patients
real‐world practice
tumour response
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Summary:Background To identify predictive factors associated with successful transition to conversion therapy following combination therapy with atezolizumab and bevacizumab in the treatment of unresectable hepatocellular carcinoma (HCC). Methods In total, 188 patients with HCC, who received atezolizumab plus bevacizumab combination therapy as the first‐line chemotherapy, were studied. Patients who achieved complete response (CR) with systemic chemotherapy alone were excluded. Clinical factors possibly linked to successful transition to conversion therapy and the achievement of cancer‐free status were identified. Results Fifteen (8.0%) patients underwent conversion therapy. In the conversion group, there was a significantly higher proportion of patients with Barcelona Clinic Liver Cancer (BCLC) stage A or B (73.3% versus [vs.] 45.1%; p = .03) and tended to have lower Child‐Pugh scores and alpha‐fetoprotein levels. Multivariate analysis revealed that BCLC stage was a predictive factor for the implementation of conversion therapy (A or B; odds ratio 3.7 [95% CI: 1.1–13]; p = .04). Furthermore, 10 (66.7%) patients achieved cancer‐free status and exhibited a smaller number of intrahepatic lesions at the start of treatment (3.5 vs. 7; p 
ISSN:1478-3223
1478-3231
DOI:10.1111/liv.15907