Concurrent Atezolizumab Plus Bevacizumab and High-Dose External Beam Radiotherapy for Highly Advanced Hepatocellular Carcinoma
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 minimall...
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creator | 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 Lin, Chen-Chun |
description | 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.
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.
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 |
doi_str_mv | 10.1093/oncolo/oyae048 |
format | Article |
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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.
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.
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.</description><identifier>ISSN: 1083-7159</identifier><identifier>ISSN: 1549-490X</identifier><identifier>EISSN: 1549-490X</identifier><identifier>DOI: 10.1093/oncolo/oyae048</identifier><identifier>PMID: 38530254</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Aged ; Antibodies, Monoclonal, Humanized - therapeutic use ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Bevacizumab - administration & dosage ; Bevacizumab - therapeutic use ; Cancer ; Carcinoma, Hepatocellular - drug therapy ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - radiotherapy ; Care and treatment ; Chemoradiotherapy - methods ; Drug therapy, Combination ; Female ; Hepatobiliary ; Hepatoma ; Humans ; Liver Neoplasms - drug therapy ; Liver Neoplasms - pathology ; Liver Neoplasms - radiotherapy ; Male ; Middle Aged ; Oncology, Experimental ; Patient outcomes ; Physiological aspects ; Radiotherapy ; Retrospective Studies ; Treatment outcome</subject><ispartof>The oncologist (Dayton, Ohio), 2024-07, Vol.29 (7), p.e922-e931</ispartof><rights>The Author(s) 2024. Published by Oxford University Press.</rights><rights>COPYRIGHT 2024 Oxford University Press</rights><rights>The Author(s) 2024. Published by Oxford University Press. 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0003-2778-3618 ; 0000-0002-2907-2679 ; 0000-0003-3007-3190</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224977/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224977/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38530254$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Su, Chung-Wei</creatorcontrib><creatorcontrib>Teng, Wei</creatorcontrib><creatorcontrib>Shen, Eric Yi-Liang</creatorcontrib><creatorcontrib>Huang, Bing-Shen</creatorcontrib><creatorcontrib>Lin, Po-Ting</creatorcontrib><creatorcontrib>Hou, Ming-Mo</creatorcontrib><creatorcontrib>Wu, Tsung-Han</creatorcontrib><creatorcontrib>Tsan, Din-Li</creatorcontrib><creatorcontrib>Hsieh, Chia-Hsun</creatorcontrib><creatorcontrib>Wang, Ching-Ting</creatorcontrib><creatorcontrib>Chai, Pei-Mei</creatorcontrib><creatorcontrib>Lin, Chun-Yen</creatorcontrib><creatorcontrib>Lin, Shi-Ming</creatorcontrib><creatorcontrib>Lin, Chen-Chun</creatorcontrib><title>Concurrent Atezolizumab Plus Bevacizumab and High-Dose External Beam Radiotherapy for Highly Advanced Hepatocellular Carcinoma</title><title>The oncologist (Dayton, Ohio)</title><addtitle>Oncologist</addtitle><description>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.
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.
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.
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Antibodies, Monoclonal, Humanized - therapeutic use</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Bevacizumab - administration & dosage</subject><subject>Bevacizumab - therapeutic use</subject><subject>Cancer</subject><subject>Carcinoma, Hepatocellular - drug therapy</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - radiotherapy</subject><subject>Care and treatment</subject><subject>Chemoradiotherapy - methods</subject><subject>Drug therapy, Combination</subject><subject>Female</subject><subject>Hepatobiliary</subject><subject>Hepatoma</subject><subject>Humans</subject><subject>Liver Neoplasms - drug therapy</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - radiotherapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Oncology, Experimental</subject><subject>Patient outcomes</subject><subject>Physiological aspects</subject><subject>Radiotherapy</subject><subject>Retrospective Studies</subject><subject>Treatment outcome</subject><issn>1083-7159</issn><issn>1549-490X</issn><issn>1549-490X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptks9rFDEUxwex2B969SgDXrxMm0yS-XGSdVutUFBEwVt4k7zZjWSSNZlZuj30bzfjrqVCySGPl8_7ki_vm2WvKTmnpGUX3ilv_YXfARLePMtOqOBtwVvy83mqScOKmor2ODuN8RchqWTli-yYNYKRUvCT7H6ZFKYQ0I35YsQ7b83dNECXf7VTzD_gFtShAU7n12a1Li59xPzqdsTgwCYEhvwbaOPHNQbY7PLeh7-g3eULvQWnMA3iBkav0NrJQsiXEJRxfoCX2VEPNuKrw32W_fh49X15Xdx8-fR5ubgpFONsnP1oXnVCYcmUauqG1KKnTHclV7zRSAnVVQ28q1XVYUOZqBgjLSgUukXN2Fn2fq-7mboBtUp2A1i5CWaAsJMejPz_xZm1XPmtpLQseVvXSeHdQSH43xPGUQ4mzobAoZ-iZKSuCBGsqhL6do-uwKI0rvdJUs24XDRpS5VoxCx4_gSVjsbBKO-wN6n_1IAKPsaA_cP3KZFzGOQ-DPIQhjTw5rHpB_zf9tkf0DC0qA</recordid><startdate>20240705</startdate><enddate>20240705</enddate><creator>Su, Chung-Wei</creator><creator>Teng, Wei</creator><creator>Shen, Eric Yi-Liang</creator><creator>Huang, Bing-Shen</creator><creator>Lin, Po-Ting</creator><creator>Hou, Ming-Mo</creator><creator>Wu, Tsung-Han</creator><creator>Tsan, Din-Li</creator><creator>Hsieh, Chia-Hsun</creator><creator>Wang, Ching-Ting</creator><creator>Chai, Pei-Mei</creator><creator>Lin, Chun-Yen</creator><creator>Lin, Shi-Ming</creator><creator>Lin, Chen-Chun</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2778-3618</orcidid><orcidid>https://orcid.org/0000-0002-2907-2679</orcidid><orcidid>https://orcid.org/0000-0003-3007-3190</orcidid></search><sort><creationdate>20240705</creationdate><title>Concurrent Atezolizumab Plus Bevacizumab and High-Dose External Beam Radiotherapy for Highly Advanced Hepatocellular Carcinoma</title><author>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 ; Lin, Chen-Chun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c343t-490d46b5ce23cc878075f13db24c48de101d67a4b7c6be813563309ace5d9ed33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antibodies, Monoclonal, Humanized - therapeutic use</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Bevacizumab - administration & dosage</topic><topic>Bevacizumab - therapeutic use</topic><topic>Cancer</topic><topic>Carcinoma, Hepatocellular - drug therapy</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - radiotherapy</topic><topic>Care and treatment</topic><topic>Chemoradiotherapy - methods</topic><topic>Drug therapy, Combination</topic><topic>Female</topic><topic>Hepatobiliary</topic><topic>Hepatoma</topic><topic>Humans</topic><topic>Liver Neoplasms - drug therapy</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - radiotherapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Oncology, Experimental</topic><topic>Patient outcomes</topic><topic>Physiological aspects</topic><topic>Radiotherapy</topic><topic>Retrospective Studies</topic><topic>Treatment outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Su, Chung-Wei</creatorcontrib><creatorcontrib>Teng, Wei</creatorcontrib><creatorcontrib>Shen, Eric Yi-Liang</creatorcontrib><creatorcontrib>Huang, Bing-Shen</creatorcontrib><creatorcontrib>Lin, Po-Ting</creatorcontrib><creatorcontrib>Hou, Ming-Mo</creatorcontrib><creatorcontrib>Wu, Tsung-Han</creatorcontrib><creatorcontrib>Tsan, Din-Li</creatorcontrib><creatorcontrib>Hsieh, Chia-Hsun</creatorcontrib><creatorcontrib>Wang, Ching-Ting</creatorcontrib><creatorcontrib>Chai, Pei-Mei</creatorcontrib><creatorcontrib>Lin, Chun-Yen</creatorcontrib><creatorcontrib>Lin, Shi-Ming</creatorcontrib><creatorcontrib>Lin, Chen-Chun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The oncologist (Dayton, Ohio)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Su, Chung-Wei</au><au>Teng, Wei</au><au>Shen, Eric Yi-Liang</au><au>Huang, Bing-Shen</au><au>Lin, Po-Ting</au><au>Hou, Ming-Mo</au><au>Wu, Tsung-Han</au><au>Tsan, Din-Li</au><au>Hsieh, Chia-Hsun</au><au>Wang, Ching-Ting</au><au>Chai, Pei-Mei</au><au>Lin, Chun-Yen</au><au>Lin, Shi-Ming</au><au>Lin, Chen-Chun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Concurrent Atezolizumab Plus Bevacizumab and High-Dose External Beam Radiotherapy for Highly Advanced Hepatocellular Carcinoma</atitle><jtitle>The oncologist (Dayton, Ohio)</jtitle><addtitle>Oncologist</addtitle><date>2024-07-05</date><risdate>2024</risdate><volume>29</volume><issue>7</issue><spage>e922</spage><epage>e931</epage><pages>e922-e931</pages><issn>1083-7159</issn><issn>1549-490X</issn><eissn>1549-490X</eissn><abstract>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.
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.
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.
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><cop>England</cop><pub>Oxford University Press</pub><pmid>38530254</pmid><doi>10.1093/oncolo/oyae048</doi><orcidid>https://orcid.org/0000-0003-2778-3618</orcidid><orcidid>https://orcid.org/0000-0002-2907-2679</orcidid><orcidid>https://orcid.org/0000-0003-3007-3190</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Antibodies, Monoclonal, Humanized - therapeutic use Antineoplastic Combined Chemotherapy Protocols - therapeutic use Bevacizumab - administration & dosage Bevacizumab - therapeutic use Cancer Carcinoma, Hepatocellular - drug therapy Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - radiotherapy Care and treatment Chemoradiotherapy - methods Drug therapy, Combination Female Hepatobiliary Hepatoma Humans Liver Neoplasms - drug therapy Liver Neoplasms - pathology Liver Neoplasms - radiotherapy Male Middle Aged Oncology, Experimental Patient outcomes Physiological aspects Radiotherapy Retrospective Studies Treatment outcome |
title | Concurrent Atezolizumab Plus Bevacizumab and High-Dose External Beam Radiotherapy for Highly Advanced Hepatocellular Carcinoma |
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