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The safety and efficacy of first-line atezolizumab plus bevacizumab in patients with unresectable hepatocellular carcinoma: A multicenter real-world study from Turkey

dc.contributor.coauthorAkyildiz, Arif
dc.contributor.coauthorGuven, Deniz Can
dc.contributor.coauthorOzluk, Ahmet Anil
dc.contributor.coauthorIsmayilov, Rashad
dc.contributor.coauthorMutlu, Emel
dc.contributor.coauthorUnal, Olcun Umit
dc.contributor.coauthorYildiz, Ibrahim
dc.contributor.coauthorIriagac, Yakup
dc.contributor.coauthorTurhal, Serdar
dc.contributor.coauthorBayram, Ertugrul
dc.contributor.coauthorTelli, Tugba Akin
dc.contributor.coauthorTurkoz, Fatma Paksoy
dc.contributor.coauthorOzcelik, Melike
dc.contributor.coauthorErciyestepe, Mert
dc.contributor.coauthorSelvi, Oguzhan
dc.contributor.coauthorGulbagci, Burcu
dc.contributor.coauthorErturk, Ismail
dc.contributor.coauthorIsleyen, Zehra Sucuoglu
dc.contributor.coauthorKahraman, Seda
dc.contributor.coauthorAkdag, Mutianur Ozkorkmaz
dc.contributor.coauthorHamitoglu, Buket
dc.contributor.coauthorUnek, Ilkay Tugba
dc.contributor.coauthorUnal, Caglar
dc.contributor.coauthorHacibekiroglu, İlhan
dc.contributor.coauthorArslan, Cagatay
dc.contributor.coauthorAzizy, Abdulmunir
dc.contributor.coauthorHelvaci, Kaan
dc.contributor.coauthorDemirci, Umut
dc.contributor.coauthorDizdar, Omer
dc.contributor.coauthorBasaran, Mert
dc.contributor.coauthorGoker, Erdem
dc.contributor.coauthorSendur, Mehmet Ali
dc.contributor.coauthorYalcin, Suayib
dc.contributor.departmentKUH (Koç University Hospital)
dc.contributor.kuauthorAkbaş, Sinem
dc.contributor.schoolcollegeinstituteKUH (KOÇ UNIVERSITY HOSPITAL)
dc.date.accessioned2025-01-19T10:27:47Z
dc.date.issued2023
dc.description.abstractThe aim of the study was to evaluate the real-world clinical outcomes of atezolizumab and bevacizumab (Atez/Bev) as the initial therapy for advanced hepatocellular carcinoma (HCC). We retrospectively analyzed 65 patients treated with Atez/Bev for advanced HCC from 22 institutions in Turkey between September 2020 and March 2023. Responses were evaluated by RECIST v1.1 criteria. The median progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan-Meier method. Cox regression model was employed to conduct multivariate analyses. The median age was 65 (range, 22-89) years, and 83.1% of the patients were male. A total of 1.5% achieved a complete response, 35.4% had a partial response, 36.9% had stable disease, and 26.2% had progressive disease. The disease control rate was 73.8% and associated with alpha-fetoprotein levels at diagnosis and concomitant antibiotic use. The incidence rates of any grade and grade ≥ 3 adverse events were 29.2% and 10.7%, respectively. At a median follow-up of 11.3 (3.4-33.3) months, the median PFS and OS were 5.1 (95% CI: 3-7.3) and 18.1 (95% CI: 6.2-29.9) months, respectively. In univariate analyses, ECOG-PS ≥ 1 (relative to 0), Child-Pugh class B (relative to A), neutrophil-to-lymphocyte ratio (NLR) > 2.9 (relative to ≤ 2.9), and concomitant antibiotic use significantly increased the overall risk of mortality. Multivariate analysis revealed that ECOG-PS ≥ 1 (HR: 2.69, P =.02), NLR > 2.9 (HR: 2.94, P =.017), and concomitant antibiotic use (HR: 4.18, P =.003) were independent predictors of OS. Atez/Bev is an effective and safe first-line therapy for advanced-stage HCC in a real-world setting. The survival benefit was especially promising in patients with a ECOG-PS score of 0, Child-Pugh class A, lower NLR, and patients who were not exposed to antibiotics during the treatment.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue45
dc.description.openaccessAll Open Access; Gold Open Access; Green Open Access
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume102
dc.identifier.doi10.1097/MD.0000000000035950
dc.identifier.eissn1473-5628
dc.identifier.issn0025-7974
dc.identifier.quartileQ2
dc.identifier.scopus2-s2.0-85176889390
dc.identifier.urihttps://doi.org/10.1097/MD.0000000000035950
dc.identifier.urihttps://hdl.handle.net/20.500.14288/25606
dc.identifier.wos1103423000055
dc.keywordsAtezolizumab
dc.keywordsBevacizumab
dc.keywordsHepatocellular carcinoma
dc.keywordsImmunotherapy
dc.language.isoeng
dc.publisherLippincott Williams and Wilkins
dc.relation.ispartofMedicine (United States)
dc.subjectRadiology, nuclear medicine and medical imaging
dc.titleThe safety and efficacy of first-line atezolizumab plus bevacizumab in patients with unresectable hepatocellular carcinoma: A multicenter real-world study from Turkey
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorAkbaş, Sinem
local.publication.orgunit1KUH (KOÇ UNIVERSITY HOSPITAL)
local.publication.orgunit2KUH (Koç University Hospital)
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relation.isParentOrgUnitOfPublication055775c9-9efe-43ec-814f-f6d771fa6dee
relation.isParentOrgUnitOfPublication.latestForDiscovery055775c9-9efe-43ec-814f-f6d771fa6dee

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