| 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 | Baseline DCP May Modify Response to Atezolizumab-Bevacizumab Versus Durvalumab-Tremelimumab in Unresectable HCC. |
| 掲載誌名 | 正式名：Liver international : official journal of the International Association for the Study of the Liver 略 称：Liver Int ISSNコード：14783231/14783223 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 46(8),pp.e70803 |
| 著者・共著者 | Kazunari Tanaka, Kunihiko Tsuji, Atsushi Hiraoka, Toshifumi Tada, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Takashi Nishimura, Toru Ishikawa, Kazuto Tajiri, Hironori Tanaka, Hidenori Toyoda, Chikara Ogawa, 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, Fujimasa Tada, Hideko Ohama, 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 | 2026/08 |
| 概要 | BACKGROUND AND AIMS:For unresectable hepatocellular carcinoma (HCC), atezolizumab plus bevacizumab (Atez/Bev) and durvalumab plus tremelimumab (Dur/Tre) are widely used first-line immunotherapies; however, biomarkers to guide regimen selection before treatment initiation remain undefined. We investigated whether baseline des-γ-carboxy prothrombin (DCP) modifies objective response rate (ORR) according to treatment regimen.METHODS:We analysed 1464 patients with unresectable HCC treated with first-line systemic therapy between 2020 and 2025 across multiple centers. Patients were divided into training and validation cohorts. Restricted cubic spline-based interaction models were used to evaluate the association between baseline DCP and ORR according to treatment regimen. The predicted absolute difference in ORR (ΔORR) between regimens was examined across continuous DCP values, with a prespecified 10% threshold considered clinically meaningful. Robustness was assessed using leave-one-center-out and repeated random-split sensitivity analyses.RESULTS:Overall ORR did not differ significantly between Atez/Bev and Dur/Tre. However, a significant interaction between baseline DCP and treatment regimen was observed in both cohorts. Atez/Bev showed a relatively stable ORR across DCP concentrations, whereas Dur/Tre showed a DCP-dependent increase in ORR. At low DCP levels, Atez/Bev was favoured; with increasing DCP levels, the relative benefit shifted toward Dur/Tre. Sensitivity analyses confirmed a consistent DCP-dependent transition pattern, although the DCP level at which ΔORR exceeded 10% varied across analyses, supporting a transition zone rather than a fixed cutoff.CONCLUSIONS:Baseline DCP may modify the relative treatment benefit between Atez/Bev and Dur/Tre in unresectable HCC. Rather than defining a rigid cutoff, DCP appears to delineate a continuum in which higher levels increasingly favour Dur/Tre, providing a practical framework for individualized immunotherapy selection. |
| DOI | 10.1111/liv.70803 |
| PMID | 42477505 |