1. Concurrent Atezolizumab Plus Bevacizumab and High-Dose External Beam Radiotherapy for Highly Advanced Hepatocellular Carcinoma.
- Author
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Su, Chung-Wei, Teng, Wei, Shen, Eric Yi-Liang, Huang, Bing-Shen, Lin, Po-Ting, Hou, Ming-Mo, Wu, Tsung-Han, Tsan, Din-Li, Hsieh, Chia-Hsun, Wang, Ching-Ting, Chai, Pei-Mei, Lin, Chun-Yen, Lin, Shi-Ming, and Lin, Chen-Chun
- Subjects
THERAPEUTIC use of antineoplastic agents ,THERAPEUTIC use of monoclonal antibodies ,PROTON therapy ,PORTAL vein ,DRUG toxicity ,BEVACIZUMAB ,DRUG therapy ,VENOUS thrombosis ,QUESTIONNAIRES ,CHEMORADIOTHERAPY ,SEVERITY of illness index ,TREATMENT effectiveness ,RADIOSURGERY ,RETROSPECTIVE studies ,DESCRIPTIVE statistics ,MULTIVARIATE analysis ,DOSE-effect relationship in pharmacology ,ODDS ratio ,MONOCLONAL antibodies ,STEREOTAXIC techniques ,MEDICAL records ,ACQUISITION of data ,DRUG efficacy ,SURVIVAL analysis (Biometry) ,COMPARATIVE studies ,CONFIDENCE intervals ,HEPATOCELLULAR carcinoma ,OVERALL survival - Abstract
Background Atezolizumab plus bevacizumab (atezo-bev) has been recommended for advanced hepatocellular carcinoma (HCC). High-dose external beam radiotherapy (RT) is recognized for its excellent local tumor control. The efficacy and safety of concurrent atezo-bev with RT for highly advanced HCC has been minimally explored. Methods In this preliminary retrospective study, we assessed patients with highly advanced HCC, characterized by Vp4 portal vein thrombosis or tumors exceeding 50% of liver volume, who received concurrent atezo-bev and RT (group A). Group A included 13 patients who received proton radiation at a dose of 72.6 GyE in 22 fractions, and one patient who received photon radiation at a dose of 54 Gy in 18 fractions. This group was compared with 34 similar patients treated atezo-bev alone as a control (group B). The primary objectives were to evaluate the objective response rate (ORR), overall survival (OS), and safety. Results Baseline characteristics were similar between groups, except for a higher incidence of Vp4 portal vein thrombosis in group A (78.6% vs. 21.4%, P = .05). Group A achieved a higher ORR (50.0% vs. 11.8%, P < .01) and a longer OS (not reached vs. 5.5 months, P = .01) after a median follow-up of 5.2 months. Multivariate analysis indicated that concurrent RT independently favored longer OS (hazard ratio: 0.18; 95% CI, 0.05-0.63, P < .01). Group A did not increase any grade adverse events (78.6% vs. 58.8%, P = .19) or severe adverse events of grade ≥ 3 (14.3% vs. 14.7%, P = .97) compared to group B. Conclusions The concurrent high-dose external beam radiotherapy appears to safely enhance the effectiveness of atezolizumab plus bevacizumab for highly advanced patients with HCC. Further studies are warranted to confirm these findings. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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