Article Sidebar
Views pdf: 27
EVALUATION OF TREATMENT OUTCOMES FOR ADVANCED HEPATOCELLULAR CARCINOMA AT MILITARY HOSPITAL 175
Main Article Content
Abstract
Objective: To describe the clinical and paraclinical characteristics, as well as treatment outcomes, of patients with advanced-stage hepatocellular carcinoma (HCC) treated with Sorafenib, Lenvatinib, and the combination regimen of Atezolizumab – Bevacizumab at Military Hospital 175. Subjects and Methods: A retrospective cross-sectional descriptive study was conducted on 117 patients diagnosed with advanced-stage HCC and treated at Military Hospital 175 from January 2022 to April 2024. Among them, 62 patients received Sorafenib, 36 received Lenvatinib, and 19 were treated with the combination of Atezolizumab – Bevacizumab. Results: The majority of patients were male. Over 50% had an Eastern Cooperative Oncology Group Performance Status (ECOG PS) score of 0–1 prior to treatment and had a history of chronic hepatitis B infection. The mean pre-treatment serum alpha-fetoprotein (AFP) level was over 1200 ng/mL. Patients treated with the Atezolizumab – Bevacizumab combination showed the most favorable outcomes, with a median overall survival (OS) of 10.6 months and median progression-free survival (PFS) of 8.4 months — higher than those in the Sorafenib and Lenvatinib groups. Conclusion: The combination regimen of Atezolizumab – Bevacizumab demonstrated superior efficacy in the treatment of advanced-stage hepatocellular carcinoma compared to Sorafenib and Lenvatinib. Male gender, chronic hepatitis B infection, and elevated AFP levels were identified as poor prognostic factors affecting treatment response and survival outcomes in advanced HCC patients.
Objective: To describe the clinical and paraclinical characteristics, as well as treatment outcomes, of patients with advanced-stage hepatocellular carcinoma (HCC) treated with Sorafenib, Lenvatinib, and the combination regimen of Atezolizumab – Bevacizumab at Military Hospital 175. Subjects and Methods: A retrospective cross-sectional descriptive study was conducted on 117 patients diagnosed with advanced-stage HCC and treated at Military Hospital 175 from January 2022 to April 2024. Among them, 62 patients received Sorafenib, 36 received Lenvatinib, and 19 were treated with the combination of Atezolizumab – Bevacizumab. Results: The majority of patients were male. Over 50% had an Eastern Cooperative Oncology Group Performance Status (ECOG PS) score of 0–1 prior to treatment and had a history of chronic hepatitis B infection. The mean pre-treatment serum alpha-fetoprotein (AFP) level was over 1200 ng/mL. Patients treated with the Atezolizumab – Bevacizumab combination showed the most favorable outcomes, with a median overall survival (OS) of 10.6 months and median progression-free survival (PFS) of 8.4 months — higher than those in the Sorafenib and Lenvatinib groups. Conclusion: The combination regimen of Atezolizumab – Bevacizumab demonstrated superior efficacy in the treatment of advanced-stage hepatocellular carcinoma compared to Sorafenib and Lenvatinib. Male gender, chronic hepatitis B infection, and elevated AFP levels were identified as poor prognostic factors affecting treatment response and survival outcomes in advanced HCC patients.
Article Details
Keywords
Hepatocellular carcinoma; HCC; Sorafenib; Lenvatinib; Atezolizumab; Bevacizumab
References
2. Rimassa L, Santoro A. Sorafenib therapy in advanced hepatocellular carcinoma: the SHARP trial. Expert Rev Anticancer Ther. 2009 Jun;9(6): 739-45. doi: 10.1586/era.09.41. PMID: 19496710.
3. Yamashita T, Kudo M, Ikeda K, Izumi N, Tateishi R, Ikeda M, Aikata H, Kawaguchi Y, Wada Y, Numata K, Inaba Y, Kuromatsu R, Kobayashi M, Okusaka T, Tamai T, Kitamura C, Saito K, Haruna K, Okita K, Kumada H. REFLECT-a phase 3 trial comparing efficacy and safety of lenvatinib to sorafenib for the treatment of unresectable hepatocellular carcinoma: an analysis of Japanese subset. J Gastroenterol. 2020 Jan;55(1):113-122. doi: 10.1007/s00535-019-01642-1. Epub 2019 Nov 12. PMID: 31720835; PMCID: PMC6942573.
4. Cheng AL, Qin S, Ikeda M, Galle PR, Ducreux M, Kim TY, Lim HY, Kudo M, Breder V, Merle P, Kaseb AO, Li D, Verret W, Ma N, Nicholas A, Wang Y, Li L, Zhu AX, Finn RS. Updated efficacy and safety data from IMbrave150: Atezolizumab plus bevacizumab vs. sorafenib for unresectable hepatocellular carcinoma. J Hepatol. 2022 Apr;76(4):862-873. doi: 10.1016/j.jhep.2021.11.030. Epub 2021 Dec 11. PMID: 34902530.
5. Chon YE, Kim DY, Kim MN, Kim BK, Kim SU, Park JY, Ahn SH, Ha Y, Lee JH, Lee KS, Kang B, Kim JS, Chon HJ, Kim DY. Sorafenib vs. Lenvatinib in advanced hepatocellular carcinoma after atezolizumab/bevacizumab failure: A real-world study. Clin Mol Hepatol. 2024 Jul;30(3): 345-359. doi: 10.3350/cmh.2023.0553. Epub 2024 Mar 12. PMID: 38468561; PMCID: PMC11261222.
6. Liu L, Lv Z, Wang M, Zhang D, Liu D, Zhu F. HBV Enhances Sorafenib Resistance in Hepatocellular Carcinoma by Reducing Ferroptosis via SRSF2-Mediated Abnormal PCLAF Splicing. Int J Mol Sci. 2023 Feb 7;24(4):3263. doi: 10.3390/ijms24043263. PMID: 36834680; PMCID: PMC9967099.
7. Hsiao YW, Sou FM, Wang JH, Chen YH, Tsai MC, Hu TH, Hung CH, Chen CH, Kuo YH. Well-controlled viremia reduces the progression of hepatocellular carcinoma in chronic viral hepatitis patients treated with lenvatinib. Kaohsiung J Med Sci. 2023 Dec;39(12):1233-1242. doi: 10.1002/ kjm2.12757. Epub 2023 Oct 16. PMID: 37843189; PMCID: PMC11895964.
8. Lu L, Zheng P, Pan Y, Huang S, Shao E, Huang Y, Wang X, Chen Y, Cuo G, Yang H, Guo W, Shi Y, Wu Z, Chen X. Trajectories of α-fetoprotein and unresectable hepatocellular carcinoma outcomes receiving atezolizumab plus bevacizumab: a secondary analysis of IMbrave150 study. Br J Cancer. 2023 Sep;129(4):620-625. doi: 10.1038/s41416-023-02334-7. Epub 2023 Jul 8. PMID: 37422527; PMCID: PMC10421902.