Concurrent Atezolizumab Plus Bevacizumab and High-Dose External Beam Radiotherapy for Highly Advanced Hepatocellular Carcinoma.
Oncologist
; 29(7): e922-e931, 2024 Jul 05.
Article
em En
| MEDLINE
| ID: mdl-38530254
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%, Pâ =â .05). Group A achieved a higher ORR (50.0% vs. 11.8%, Pâ <â .01) and a longer OS (not reached vs. 5.5 months, Pâ =â .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, Pâ <â .01). Group A did not increase any grade adverse events (78.6% vs. 58.8%, Pâ =â .19) or severe adverse events of gradeâ ≥â 3 (14.3% vs. 14.7%, Pâ =â .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.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Carcinoma Hepatocelular
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Anticorpos Monoclonais Humanizados
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Bevacizumab
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Neoplasias Hepáticas
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article