| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Prospective Study of Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma Based on Hepatobiliary Phase of Gd-EOB-DTPA-MRI. |
| 掲載誌名 | 正式名：Hepatology research : the official journal of the Japan Society of Hepatology 略 称：Hepatol Res ISSNコード：13866346/13866346 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Tomoko Aoki, Masatoshi Kudo, Kazuomi Ueshima, Masakatsu Tsurusaki, Keitaro Sofue, Yoshihiko Yano, Hidenori Toyoda, Atsushi Hiraoka, Takeshi Hatanaka, Atsushi Naganuma, Satoru Kakizaki, Norio Itokawa, Masanori Atsukawa, Kazuhito Kawata, Kazuto Tajiri, Joji Tani, Toru Ishikawa, Masahiro Morita, Hirokazu Chishina, Masahiro Takita, Satoru Hagiwara, Yasunori Minami, Takashi Kumada, Naoshi Nishida, Yuzo Kodama |
| 発行年月 | 2026/03 |
| 概要 | BACKGROUND:Signal intensity on the hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-magnetic resonance imaging (MRI) reflects Wnt/β-catenin signaling activity in hepatocellular carcinoma (HCC), and has been associated with poor response to immune monotherapy. However, whether such imaging findings predict resistance to combination immunotherapy has not been prospectively validated.METHODS:This multicenter prospective study enrolled 152 patients with unresectable HCC treated with atezolizumab plus bevacizumab across 12 Japanese centers. All had Child-Pugh class A liver function and underwent Gd-EOB-DTPA-MRI prior to treatment. Hyperintensity was defined as a relative enhancement ratio ≥ 0.9. Treatment outcomes, including objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and time to partial response (TtPR), were compared between patients with and without hyperintense nodules.RESULTS:Of the 152 patients, 82 received immunotherapy as the first-line and 70 as a later-line therapy. Hyperintense nodules were identified in 57 (37.5%) patients. The hyperintense group showed a higher ORR (36.8% vs. 22.1%) and comparable PFS (8.9 vs. 7.9 months) and OS (16.7 vs. 23.9 months), though not statistically significant. The TtPR was significantly shorter in the hyperintense group (median 26.0 months vs. not reached, p = 0.033), although mainly influenced by prior systemic therapy. Overall, hyperintense lesions were not associated with reduced efficacy and tended to show more favorable responses.CONCLUSION:This prospective multicenter study demonstrates that hepatobiliary hyperintensity on Gd-EOB-DTPA-enhanced MRI-an imaging surrogate of Wnt/β-catenin activation-does not indicate resistance to atezolizumab plus bevacizumab. These findings support the use of combination immunotherapy in molecularly "immune-cold" HCC. |
| DOI | 10.1111/hepr.70157 |
| PMID | 41862780 |