Potential feasibility of atezolizumab-bevacizumab therapy in patients with hepatocellular carcinoma treated with tyrosine-kinase inhibitors. Issue 11 (November 2022)

• Record Type: Journal Article
• Authors: Stefanini, Benedetta; Bucci, Laura; Santi, Valentina; Reggidori, Nicola; Rampoldi, Davide; Lani, Lorenzo; Granito, Alessandro; Sangiovanni, Angelo; Cabibbo, Giuseppe; Farinati, Fabio; Campani, Claudia; Foschi, Francesco Giuseppe; Svegliati-Baroni, Gianluca; Raimondo, Giovanni; Gasbarrini, Antonio; Mega, Andrea; Biasini, Elisabetta; Sacco, Rodolfo; Morisco, Filomena; Caturelli, Eugenio; Vidili, Gianpaolo; Azzaroli, Francesco; Giannini, Edoardo G.; Rapaccini, Gian Ludovico; Brunetto, Maurizia Rossana; Masotto, Alberto; Nardone, Gerardo; Di Marco, Mariella; Magalotti, Donatella; Trevisani, Franco; Biselli, Maurizio; Caraceni, Paolo; Gramenzi, Annagiulia; Tovoli, Francesco; Granito, Alessandro; Muratori, Luca; Benevento, Francesca; Allegrini, Gloria; Cammà, Calogero; Celsa, Ciro; Giuffrida, Paolo; Stornello, Caterina; Grova, Mauro; Giacchetto, Carmelo Marco; Rancatore, Gabriele; Grassini, Maria Vittoria; Adotti, Valentina; Gitto, Stefano; Marra, Fabio; Rosi, Martina; Bevilacqua, Vittoria; Borghi, Alberto; Gardini, Andrea Casadei; Conti, Fabio; Dall'Aglio, Anna Chiara; Ercolani, Giorgio; Mirici, Federica; Allegrini, Gloria; de Matthaeis, Nicoletta; Ponziani, Francesca Romana; Missale, Gabriele; Olivani, Andrea; Guarino, Maria; Cossiga, Valentina; Capasso, Mario; Cela, Ester Marina; Facciorusso, Antonio; Lauria, Valentina; Ghittoni, Giorgia; Pelecca, Giorgio; Chegai, Fabrizio; Coratella, Fabio; Ortenzi, Mariano; Dell'Isola, Serena; Franzè, Maria Stella; Saitta, Carlo; Sauchella, Assunta; Dajti, Elton; Ravaioli, Federico; Pieri, Giulia; Torres, Maria Corina Plaz; Oliveri, Filippo; Ricco, Gabriele; Romagnoli, Veronica; Inno, Alessandro; Marchetti, Fabiana; Coccoli, Pietro; Malerba, Antonio; Cappelli, Alberta; Golfieri, Rita; Mosconi, Cristina; Matteo Renzulli, ;
• Is Part Of: Digestive and liver disease. Volume 54:Issue 11(2022)
• Page Start: 1563
• Page End: 1572
• Publication Date: 2022-11
• Subjects: Hepatocellular carcinoma -- Systemic therapy -- Atezolizumab-bevacizumab -- Tirosin-kinase inhibitor; HCC Hepatocellular carcunoma -- Atezo-Beva Atezolizumab-bevacizumab -- OS Overal survival -- PFS Pregression free survival -- TKI Tyrosine-kinasi inhibtor -- Durva-Treme Durvalumab-Tremelimimab -- PDL-1 anti-Programmed Death Ligand protein 1 -- CTLA-4 anti-Cytotoxic T-Lmphocyte-Associated protein 4 -- AFP Alpha1-fetoprotein -- MELD Model of End Liver Disease -- BCLC Barcelona Clinic Liver Cancer -- TAE Transarterial embolization -- TACE Transarterial chemoembolization -- TARE Transarterial radioembolization; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2022.07.003
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background: The combination of atezolizumab-bevacizumab has been proven to be superior to sorafenib for the treatment of unresectable hepatocellular carcinoma not amenable to locoregional treatments, becoming the standard of care of systemic therapy. Aim: This study aimed at assessing real-world feasibility of atezolizumab-bevacizumab in patients treated with tyrosine-kinase inhibitors. Methods: Among 1447 patients treated with tyrosine-kinase inhibitors from January 2010 to December 2020, we assessed the percentage of those potentially eligible to atezolizumab-bevacizumab (according to IMbrave-150 trial criteria), and the overall survival of eligible and non-eligible patients. Results: 422 (29%) patients were qualified for atezolizumab-bevacizumab therapy. The main exclusion causes were Child-Pugh class and Performance Status. Adopting the more permissive inclusion criteria of SHARP trial, 535 patients became eligible. The median overall survival of tyrosine-kinase inhibitors patients was 14.9 months, longer in eligible patients than in their counterpart due to better baseline liver function and oncological features. Conclusion: Real-world data indicate that less than one-third of hepatocellular carcinoma patients treated with tyrosine-kinase inhibitors are potentially eligible to atezolizumab-bevacizumab according to the registration trial criteria. These patients have a longer survival than the non-eligible ones. If the selection criteria of atezolizumab-bevacizumab trial are maintained in clinical practice, tyrosine-kinase inhibitors will remain the most used systemic therapy for hepatocellular carcinoma patients.