| 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 | Optimizing bevacizumab exposure in atezolizumab-based therapy for unresectable hepatocellular carcinoma: A nationwide real-world study. |
| 掲載誌名 | 正式名：Hepatology (Baltimore, Md.) 略 称：Hepatology ISSNコード：15273350/02709139 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Kaho Aoe, Toshifumi Tada, Atsushi Hiraoka, Tomomitsu Matono, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Takashi Nishimura, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Tanaka, Hidenori Toyoda, Chikara Ogawa, Takeshi Hatanaka, Satoru Kakizaki, Kazuhito Kawata, Naganuma Atsushi, Hisashi Kosaka, Hidekatsu Kuroda, Yutaka Yata, Hiroki Nishikawa, Michitaka Imai, Tomoko Aoki, Hironori Ochi, Hideyuki Tamai, Shohei Komatsu, Takanori Matsuura, Yoshihide Ueda, Soo Ki Kim, Hideko Ohama, Fujimasa Tada, Shinichiro Nakamura, Yoshiko Nakamura, Osamu Yoshida, Kazuhiro Nouso, Asahiro Morishita, Norio Itokawa, Tomomi Okubo, Taeang Arai, Akemi Tsutsui, Takuya Nagano, Shinya Fukunishi, Kazunari Tanaka, Yuichi Koshiyama, Yuki Kanayama, Hidenao Noritake, Hirayuki Enomoto, Kosuke Matsui, Masaki Kaibori, Jumpei Okamura, Takumi Fukumoto, Yoichi Hiasa, Masatoshi Kudo, Takashi Kumada, |
| 発行年月 | 2026/05 |
| 概要 | BACKGROUND AIMS:Atezolizumab plus bevacizumab (Atezo/Bev) is administered for unresectable hepatocellular carcinoma (HCC), with bevacizumab dosed by body weight, which may not adequately reflect body composition. This study evaluated the association between BSA-adjusted bevacizumab dosing, expressed as the bevacizumab-BSA index (BBI), and outcomes.APPROACH RESULTS:This retrospective study included 1,507 unresectable HCC patients treated with Atezo/Bev at 30 Japanese institutions. BBI was the ratio of actual to standard dose per BSA. Restricted cubic spline analyses identified the optimal BBI range. Outcomes were compared among BBI groups. Spline analysis revealed a nonlinear association between BBI and overall survival (OS), with an optimal BBI range of 106-121%. Accordingly, the patients were classified into Under (n=924), Target (n=522), and Over (n=61) groups. The median progression-free survival (PFS) was significantly longer in the Target group than in the non-Target group (10.3 vs. 6.5 months, p<0.001), and the median OS was prolonged (24.9 vs. 19.2 months, p=0.008). Multivariable analysis demonstrated that the Target BBI group was independently associated with improved PFS (hazard ratio [HR], 0.807; 95% confidence interval [CI], 0.715-0.910; p<0.001) and OS (HR, 0.850; 95% CI, 0.733-0.985; p=0.031). The objective response rate was significantly higher in the Target group (p=0.023), while treatment-related adverse event rates were comparable across the BBI groups, with no significant differences in proteinuria, hypertension, or other toxicities.CONCLUSIONS:BSA-adjusted bevacizumab dosing was associated with improved efficacy without increased toxicity in patients with unresectable HCC treated with Atezo/Bev. |
| DOI | 10.1097/HEP.0000000000001781 |
| PMID | 42090542 |