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Войти в исследования Atezolizumab plus bevacizumab versus lenvatinib for unresectable hepatocellular carcinoma: a large real-life worldwide population.
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Casadei-Gardini Andrea, Rimini Margherita, Tada Toshifumi, Suda Goki, Shimose Shigeo, Kudo Masatoshi, Cheon Jaekyung, Finkelmeier Fabian, Lim Ho Yeong, Rimassa Lorenza, Presa José, Masi Gianluca, Yoo Changhoon, Lonardi Sara, Tovoli Francesco, Kumada Takashi, Sakamoto Naoya, Iwamoto Hideki, Aoki Tomoko, Chon Hong Jae, Himmelsbach Vera, Pressiani Tiziana, Montes Margarida, Vivaldi Caterina, Soldà Caterina, Piscaglia Fabio, Hiraoka Atsushi, Sho Takuya, Niizeki Takashi, Nishida Naoshi, Steup Christoph, Iavarone Massimo, Di Costanzo Giovanni, Marra Fabio, Scartozzi Mario, Tamburini Emiliano, Cabibbo Giuseppe, Foschi Francesco Giuseppe, Silletta Marianna, Hirooka Masashi, Kariyama Kazuya, Tani Joji, Atsukawa Masanori, Takaguchi Koichi, Itobayashi Ei, Fukunishi Shinya, Tsuji Kunihiko, Ishikawa Toru, Tajiri Kazuto, Ochi Hironori, Yasuda Satoshi, Toyoda Hidenori, Ogawa Chikara, Nishimura Takashi, Hatanaka Takeshi, Kakizaki Satoru, Shimada Noritomo, Kawata Kazuhito, Tada Fujimasa, Ohama Hideko, Nouso Kazuhiro, Morishita Asahiro, Tsutsui Akemi, Nagano Takuya, Itokawa Norio, Okubo Tomomi, Arai Taeang, Imai Michitaka, Kosaka Hisashi, Naganuma Atsushi, Koizumi Yohei, Nakamura Shinichiro, Kaibori Masaki, Iijima Hiroko, Hiasa Yoichi, Burgio Valentina, Persano Mara, Della Corte Angelo, Ratti Francesca, De Cobelli Francesco, Aldrighetti Luca, Cascinu Stefano, Cucchetti Alessandro
Аннотация
METHODS: Clinical features of lenvatinib and atezolizumab plus bevacizumab patients were balanced through inverse probability of treatment weighting (IPTW) methodology, which weights patients' characteristics and measured outcomes of each patient in both treatment arms. Overall survival (OS) was the primary end-point.
RESULTS: The analysis included 1341 patients who received lenvatinib, and 864 patients who received atezolizumab plus bevacizumab. After IPTW adjustment, atezolizumab plus bevacizumab did not show a survival advantage over lenvatinib HR 0.97 (p = 0.739). OS was prolonged by atezolizumab plus bevacizumab over lenvatinib in viral patients (HR: 0.76; p = 0.024). Conversely, OS was prolonged by lenvatinib in patients with non-alcoholic steatohepatitis/non-alcoholic fatty liver disease (HR: 1.88; p = 0.014). In the IPTW-adjusted population, atezolizumab plus bevacizumab provided better safety profile for most of the recorded adverse events.
CONCLUSION: Our study did not identify any meaningful difference in OS between atezolizumab plus bevacizumab and lenvatinib. Although some hints are provided suggesting that patients with non-alcoholic steatohepatitis/non-alcoholic fatty liver disease might benefit more from lenvatinib therapy and patients with viral aetiology more from atezolizumab plus bevacizumab.