Safety and efficacy of atezolizumab plus bevacizumab in elderly patients with hepatocellular carcinoma: A multicenter analysis.
Safety and efficacy of atezolizumab plus bevacizumab in elderly patients with hepatocellular carcinoma: A multicenter analysis.
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DOI：
10.1002/cam4.4763
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发表时间：
2022-10
期刊：
影响因子：
4
通讯作者：
Hiasa, Yoichi
中科院分区：
文献类型：
--
作者：
Tada, Toshifumi;Kumada, Takashi;Hiraoka, Atsushi;Hirooka, Masashi;Kariyama, Kazuya;Tani, Joji;Atsukawa, Masanori;Takaguchi, Koichi;Itobayashi, Ei;Fukunishi, Shinya;Tsuji, Kunihiko;Ishikawa, Toru;Tajiri, Kazuto;Ochi, Hironori;Yasuda, Satoshi;Toyoda, Hidenori;Ogawa, Chikara;Nishimura, Takashi;Hatanaka, Takeshi;Kakizaki, Satoru;Shimada, Noritomo;Kawata, Kazuhito;Tanaka, Takaaki;Ohama, Hideko;Nouso, Kazuhiro;Morishita, Asahiro;Tsutsui, Akemi;Nagano, Takuya;Itokawa, Norio;Okubo, Tomomi;Arai, Taeang;Imai, Michitaka;Naganuma, Atsushi;Koizumi, Yohei;Nakamura, Shinichiro;Joko, Kouji;Iijima, Hiroko;Hiasa, Yoichi
阿替唑单抗联合贝伐单抗(ATEZ/BEV)治疗老年不能切除的肝细胞癌(HCC)的安全性和有效性尚未得到充分的研究。对317例接受ATEZ/BEV治疗的肝癌患者进行了研究。我们使用逆概率加权(IPW)分析比较了接受ATEZ/BEV治疗的老年和非老年肝细胞癌患者的存活率和不良事件发生的频率。经IPW调整的单因素分析显示，老年与较差的总体或无进展生存率无关(风险比[HR]，1.239；95%可信区间[CI]，0.640-2.399；p=0.526和HR，1.256；95%CI，0.871-1.811；p=0.223)。关于与治疗相关的不良事件，≥10%的患者出现任何程度的乏力、蛋白尿、食欲下降、高血压和肝脏损伤。老年组和非老年组之间与治疗相关的不良事件没有显著差异。在对75-79岁、80-84岁或 ≥ 85 岁的老年患者进行的亚组分析中，这些年龄组之间的累积总体或无进展生存率没有显著差异(p=0.960和0.566)。此外，除了任何级别的蛋白尿外，这三个年龄组之间与治疗相关的不良事件没有显著差异。在对接受ATEZ/BEV作为一线系统治疗的患者进行的亚组分析中，老年组和非老年组在累积总体或无进展生存率方面没有显著差异(p=0.728和0.805)。无论年龄大小，ATEZ/BEV在不能切除的肝细胞癌患者中都可以有效和安全地使用。接受阿替唑单抗加贝伐单抗治疗的老年患者和非老年患者在累积总体或无进展存活率方面没有显著差异。在这个队列中，老年患者和非老年患者在治疗相关不良事件方面没有显著差异。在不能切除的肝细胞癌患者中，无论年龄大小，阿替唑单抗联合贝伐单抗均可安全有效地应用。
The safety and efficacy of atezolizumab plus bevacizumab (Atez/Bev) in elderly patients with unresectable hepatocellular carcinoma (HCC) have not been sufficiently investigated. A total of 317 patients with HCC treated with Atez/Bev were studied. We compared the survival and frequency of adverse events in elderly versus non‐elderly patients with HCC who were treated with Atez/Bev using an analysis of inverse probability weighting (IPW). Univariate analysis adjusted with IPW showed that being elderly is not associated with worse overall or progression‐free survival (hazard ratio [HR], 1.239; 95% confidence interval [CI], 0.640–2.399; p = 0.526 and HR, 1.256; 95% CI, 0.871–1.811; p = 0.223, respectively). Regarding treatment‐related adverse events, any grade of fatigue, proteinuria, decreased appetite, hypertension, and liver injury occurred in ≥10% of patients. There were no significant differences in treatment‐related adverse events between the elderly and non‐elderly groups. In a subgroup analysis of elderly patients aged 75–79, 80–84, or ≥ 85 years, there were no significant differences in cumulative overall or progression‐free survival among these age groups (p = 0.960 and 0.566, respectively). In addition, there were no significant differences in treatment‐related adverse events among these three age groups, except for proteinuria of any grade. In a subgroup analysis of patients treated with Atez/Bev as first‐line systemic therapy, there were no significant differences in cumulative overall or progression‐free survival between the elderly and non‐elderly groups (p = 0.728 and 0.805, respectively). Atez/Bev can be used efficaciously and safely in spite of age in patients with unresectable HCC. There were no significant differences in cumulative overall or progression‐free survival between elderly and non‐elderly patients treated with atezolizumab plus bevacizumab. There were no significant differences in treatment‐related adverse events between elderly and non‐elderly patients of this cohort. Atezolizumab plus bevacizumab can be used safely and efficaciously regardless of age in patients with unresectable HCC.
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