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

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dc.authoridAkyildiz, Arif/0000-0002-4452-2076
dc.authoridIsmayilov, Rashad/0000-0002-7093-2722
dc.authoridkahraman, seda/0000-0002-5328-6554
dc.authoridMUTLU, EMEL/0000-0002-1008-2527
dc.authoridBayram, Ertugrul/0000-0001-8713-7613
dc.authorwosidYildiz, Ibrahim/AAF-9885-2019
dc.authorwosidSendur, Mehmet Ali Nahit/H-7555-2014
dc.authorwosidAkyildiz, Arif/IQW-4417-2023
dc.authorwosidIsmayilov, Rashad/AAY-2687-2021
dc.authorwosidunal, olcun umit/IST-6684-2023
dc.authorwosidkahraman, seda/KHU-2244-2024
dc.contributor.authorAkyildiz, Arif
dc.contributor.authorGuven, Deniz Can
dc.contributor.authorOzluk, Ahmet Anil
dc.contributor.authorIsmayilov, Rashad
dc.contributor.authorMutlu, Emel
dc.contributor.authorUnal, Olcun Umit
dc.contributor.authorYildiz, Ibrahim
dc.date.accessioned2024-05-19T14:39:09Z
dc.date.available2024-05-19T14:39:09Z
dc.date.issued2023
dc.departmentİstinye Üniversitesien_US
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.en_US
dc.identifier.doi10.1097/MD.0000000000035950
dc.identifier.issn0025-7974
dc.identifier.issn1536-5964
dc.identifier.issue45en_US
dc.identifier.pmid37960746en_US
dc.identifier.scopus2-s2.0-85176889390en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.urihttps://doi.org10.1097/MD.0000000000035950
dc.identifier.urihttps://hdl.handle.net/20.500.12713/4715
dc.identifier.volume102en_US
dc.identifier.wosWOS:001103423000055en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofMedicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.snmz20240519_kaen_US
dc.subjectAtezolizumaben_US
dc.subjectBevacizumaben_US
dc.subjectHepatocellular Carcinomaen_US
dc.subjectImmunotherapyen_US
dc.titleThe safety and efficacy of first-line atezolizumab plus bevacizumab in patients with unresectable hepatocellular carcinoma: A multicenter real-world study from Turkeyen_US
dc.typeArticleen_US

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