| 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 | Clinical Characteristics, Predictive Factors, and the Impact of Antithrombotic Therapy on Bleeding Events in Unresectable Hepatocellular Carcinoma Treated With Atezolizumab Plus Bevacizumab. |
| 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 | Fujimasa Tada, Atsushi Hiraoka, Hideko Ohama, Toshifumi Tada, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Tanaka, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Kazuhito Kawata, Atsushi Naganuma, Hisashi Kosaka, Tomomitsu Matono, Yoshihide Ueda, Hidekatsu Kuroda, Yutaka Yata, Hiroki Nishikawa, Michitaka Imai, Tomoko Aoki, Hironori Ochi, Jumpei Okamura, Hideyuki Tamai, Shinichiro Nakamura, Yoshiko Nakamura, Osamu Yoshida, Kazuhiro Nouso, Asahiro Morishita, Norio Itokawa, Tomomi Okubo, Taeang Arai, Akemi Tsutsui, Takuya Nagano, Kazunari Tanaka, Yuichi Koshiyama, Yuki Kanayama, Hidenao Noritake, Shohei Komatsu, Takumi Fukumoto, Takanori Matsuura, Soo Ki Kim, Hirayuki Enomoto, Kosuke Matsui, Masaki Kaibori, Yoichi Hiasa, Masatoshi Kudo, Takashi Kumada, |
| 発行年月 | 2026/04 |
| 概要 | AIM:Atezolizumab plus bevacizumab (Atez/Bev) in unresectable hepatocellular carcinoma (uHCC) is a standard first-line therapy, but bleeding-related adverse events (BL-AEs) remain clinically concerning, particularly in real-world patients with advanced tumors, portal hypertension, or undergoing antithrombotic therapy (ATT). We aimed to evaluate whether ATT increases bleeding risk, identify pretreatment factors associated with BL-AEs, and assess the impact of bleeding on progression-free survival (PFS) and overall survival (OS) in patients with uHCC treated with Atez/Bev.METHODS:This multicenter retrospective study included 981 patients with uHCC treated with Atez/Bev. BL-AEs were identified by clinical assessment, imaging, or endoscopy. Predictors of BL-AEs were analyzed using logistic regression. Survival outcomes were compared by Kaplan-Meier method, with inverse probability weighting (IPW) applied to adjust for baseline imbalances.RESULTS:BL-AEs occurred in 102 patients (10.4%) and led to treatment discontinuation in 2.7% patients. Independent predictors of BL-AEs included advanced tumor burden components, such as Vp ≥ 3 portal vein invasion and extrahepatic metastasis. Neither ATT nor portal hypertension-related factors were associated with bleeding risk. PFS did not differ between groups, whereas OS was significantly shorter in the BL group before IPW adjustment than after IPW adjustment.CONCLUSIONS:During Atez/Bev therapy, BL-AEs were primarily associated with advanced tumor burden rather than with ATT or baseline portal hypertension-related factors. Although BL-AEs were associated with poorer OS, this should be interpreted cautiously, as bleeding may reflect aggressive tumor biology rather than a direct mortality cause. Careful monitoring for bleeding complications may be required in patients with advanced tumor burden receiving Atez/Bev. |
| DOI | 10.1111/hepr.70190 |
| PMID | 42011150 |