A Real-World Comparative Analysis of Atezolizumab Plus Bevacizumab and Transarterial Chemoembolization Plus Radiotherapy in Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombosis
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Treatment Regimens
2.3. Assessment of Outcomes
2.4. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. One-Year Survival and PFS in the Entire Population
3.3. Treatment Responses and AEs
3.4. Subgroup Analysis
3.5. Factors Associated with One-Year Survival and PSM Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Total (n = 97) | General Model | Propensity Score Matching Model | ||||
---|---|---|---|---|---|---|---|
Ate/Bev Group | TACE + RT Group | p-Value | Ate/Bev Group | TACE + RT Group | p-Value | ||
(n = 37) | (n = 60) | (n = 27) | (n = 32) | ||||
Age, years | 59.1 ± 10.7 | 60.7 ± 12.9 | 58.1 ± 9.0 | 0.283 | 58.1 ± 12.0 | 59.6 ± 9.1 | 0.578 |
Male | 87 (89.7%) | 35 (94.6%) | 52 (86.7%) | 0.366 | 25 (92.6%) | 30 (93.8%) | 1.000 |
Cause (n, %) | 0.074 | 0.954 | |||||
HBV | 73 (76.0%) | 24 (64.9%) | 49 (81.7%) | 20 (74.1%) | 25 (78.1%) | ||
Others | 23 (24.2%) | 13 (35.1%) | 11 (18.3%) | 7 (25.9%) | 7 (21.9%) | ||
Treatment-naïve (n, %) | 67 (69.1%) | 22 (59.5%) | 45 (75.0%) | 0.167 | 16 (59.3%) | 25 (78.1%) | 0.199 |
AST, IU/mL | 70.5 ± 46.1 | 64.1 ± 35.6 | 74.5 ± 51.5 | 0.245 | 68.5 ± 38.2 | 78.5 ± 56.6 | 0.425 |
ALT, IU/mL | 42.2 ± 31.0 | 35.0 ± 23.7 | 46.5 ± 33.6 | 0.051 | 38.6 ± 26.6 | 49.2 ± 41.3 | 0.240 |
T.bil, mg/dL | 1.0 ± 0.6 | 0.9 ± 0.7 | 1.1 ± 0.5 | 0.205 | 1.0 ± 0.7 | 1.1 ± 0.5 | 0.945 |
Alb, g/dL | 3.7 ± 0.6 | 3.8 ± 0.4 | 3.7 ± 0.7 | 0.158 | 3.9 ± 0.4 | 3.9 ± 0.4 | 0.855 |
PLT, 103/μL | 151.7 ± 64.2 | 162.6 ± 66.0 | 145.0 ± 62.6 | 0.190 | 169.0 ± 69.2 | 151.9 ± 66.6 | 0.339 |
INR. | 1.1 [1.0; 1.2] | 1.1 [1.0; 1.1] | 1.1 [1.0; 1.2] | 0.293 | 1.1 [1.0; 1.2] | 1.1 [1.0; 1.2] | 0.976 |
Cr, mg/dL | 0.8 [0.7; 0.9] | 0.7 [0.7; 0.9] | 0.8 [0.6; 0.9] | 0.442 | 0.7 [0.7; 0.9] | 0.9 [0.6; 1.0] | 0.488 |
CP class A | 84 (86.6%) | 34 (91.9%) | 50 (83.3%) | 0.371 | 24 (88.9%) | 27 (84.4%) | 0.902 |
AFP, ng/mL | 240.3 [23.9; 1917.6] | 484.4 [40.0; 3175.0] | 189.2 [20.4; 1408.4] | 0.277 | 237.0 [29.9; 2730.0] | 274.6 [27.1; 1408.4] | 0.632 |
PIVKA, mAU/mL | 1723.0 [161.0; 6670.0] | 2877.0 [230.0; 7521.0] | 1344.0 [140.9; 5870.5] | 0.653 | 2877.0 [245.4; 7753.3] | 3436.3 [208.8; 7065.6] | 0.849 |
Tumor Size, cm | 8.2 ± 4.6 | 7.6 ± 4.8 | 8.5 ± 4.5 | 0.354 | 7.8 ± 5.0 | 8.8 ± 4.9 | 0.448 |
Multiple intrahepatic HCC (≥2 nodule) | 68 (70.1%) | 27 (73.0%) | 41 (68.3%) | 0.798 | 19 (70.4%) | 23 (71.9%) | 1.000 |
Bilobar intrahepatic HCC | 34 (35.1%) | 14 (37.8%) | 20 (33.3%) | 0.816 | 10 (37.0%) | 12 (37.5%) | 1.000 |
VP4 PVTT | 45 (46.4%) | 15 (40.5%) | 30 (50.0%) | 0.485 | 13 (48.1%) | 15 (46.9%) | 1.000 |
Adverse Events (AEs) | Total | Ate/Bev | TACE + RT | p-Value |
---|---|---|---|---|
(n = 97) | (n = 37) | (n = 60) | ||
AE yes | 16 (16.5%) | 7 (18.9%) | 9 (15.0%) | 0.823 |
AE types according to grades | ||||
Grade 1–2 | 0.068 | |||
- Proteinuria | 3 (3.1%) | 3 (8.1%) | 0 (0.0%) | |
- Others | 2 (2.1%) | 1 (2.7%) | 1 (1.7%) | |
Grade 3–4 | 0.524 | |||
- Varix bleeding | 7 (7.2%) | 2 (5.4%) | 5 (8.3%) | |
- Hepatic encephalopathy | 2 (2.1%) | 1 (2.7%) | 1 (1.7%) | |
- HCC rupture | 2 (2.1%) | 0 (0.0%) | 2 (3.3%) |
Characteristics | HR | 95% CI | p-Value |
---|---|---|---|
Age ≥ 60 | 1.75 | 0.86, 3.54 | 0.12 |
Male | 2.15 | 0.51, 9.03 | 0.3 |
Ate/Bev Tx. | 0.38 | 0.15, 1.00 | 0.049 |
AST ≥ 60, IU/mL | 1.47 | 0.73, 2.96 | 0.3 |
ALT ≥ 40, IU/mL | 1.16 | 0.58, 2.31 | 0.7 |
T.bil ≥ 1.0, mg/dL | 1.97 | 0.98, 3.96 | 0.058 |
Alb ≤ 3.5, g/dL | 1.13 | 0.46, 2.75 | 0.8 |
INR ≥ 1.1 | 1.00 | 0.50, 2.00 | 1.0 |
AFP ≥ 200, ng/mL | 0.93 | 0.47, 1.87 | 0.8 |
PIVKA ≥ 40, mAU/mL | 0.89 | 0.31, 2.55 | 0.8 |
Size ≥ 8.0, cm | 1.42 | 0.71, 2.85 | 0.3 |
Multiple intrahepatic HCC | 0.63 | 0.31, 1.28 | 0.2 |
Bilobar intrahepatic HCC | 0.98 | 0.46, 2.07 | 1.0 |
VP4 PVTT | 1.33 | 0.66, 2.66 | 0.4 |
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Lee, S.K.; Kwon, J.H.; Lee, S.W.; Lee, H.L.; Kim, H.Y.; Kim, C.W.; Song, D.S.; Chang, U.I.; Yang, J.M.; Nam, S.W.; et al. A Real-World Comparative Analysis of Atezolizumab Plus Bevacizumab and Transarterial Chemoembolization Plus Radiotherapy in Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombosis. Cancers 2023, 15, 4423. https://doi.org/10.3390/cancers15174423
Lee SK, Kwon JH, Lee SW, Lee HL, Kim HY, Kim CW, Song DS, Chang UI, Yang JM, Nam SW, et al. A Real-World Comparative Analysis of Atezolizumab Plus Bevacizumab and Transarterial Chemoembolization Plus Radiotherapy in Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombosis. Cancers. 2023; 15(17):4423. https://doi.org/10.3390/cancers15174423
Chicago/Turabian StyleLee, Soon Kyu, Jung Hyun Kwon, Sung Won Lee, Hae Lim Lee, Hee Yeon Kim, Chang Wook Kim, Do Seon Song, U Im Chang, Jin Mo Yang, Soon Woo Nam, and et al. 2023. "A Real-World Comparative Analysis of Atezolizumab Plus Bevacizumab and Transarterial Chemoembolization Plus Radiotherapy in Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombosis" Cancers 15, no. 17: 4423. https://doi.org/10.3390/cancers15174423