Treatment Outcomes of Tyrosine Kinase Inhibitors and Durvalumab Plus Tremelimumab After Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma.

IF 1.6 4区医学 Q4 ONCOLOGY Anticancer research Pub Date : 2025-01-01 DOI:10.21873/anticanres.17412

Nobuaki Ishihara, Shohei Komatsu, Yoshihiko Yano, Yoshimi Fujishima, Jun Ishida, Masahiro Kido, Hidetoshi Gon, Kenji Fukushima, Takeshi Urade, Toshihiko Yoshida, Kentaro Tai, Keisuke Arai, Hiroaki Yanagimoto, Hirochika Toyama, Takanori Matsuura, Toshifumi Tada, Yuzo Kodama, Takumi Fukumoto

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Abstract

Background/aim: Atezolizumab plus bevacizumab (AteBev) is widely used as a first-line treatment for advanced hepatocellular carcinoma (HCC). However, evidence regarding the optimal drug sequence following AteBev treatment is limited. This study aimed to compare the treatment outcomes between tyrosine kinase inhibitors (TKIs) and durvalumab plus tremelimumab (DurTre) following AteBev treatment.

Patients and methods: Overall, 134 consecutive patients who received AteBev for advanced HCC were enrolled in this study. Treatment outcomes were retrospectively compared between TKIs (AteBev→TKI group) and DurTre (AteBev→DurTre group).

Results: The AteBev→TKI and Ate→DurTre groups included 46 and 7 patients, respectively. The AteBev→TKI group had significantly longer median progression-free survival after second-line treatment (3.6 vs. 0.94 months, p<0.001). The disease control rate was significantly higher in the AteBev→TKI group (p=0.020). The serum alpha-fetoprotein levels significantly decreased at one month in the AteBev→TKI group (0.909 vs. 1.435, p=0.035), whereas the albumin-bilirubin score significantly decreased at one month in the AteBev→TKI group (0.875 vs. 0.952, p=0.017). Each group reported no new unmanageable adverse events.

Conclusion: TKIs may be a more optimal drug sequence than DurTre after AteBev treatment from an oncological perspective. TKIs following AteBev treatment require careful monitoring for deteriorating liver function.

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酪氨酸激酶抑制剂和Durvalumab加Tremelimumab在Atezolizumab加Bevacizumab治疗肝细胞癌后的治疗效果。

背景/目的：Atezolizumab联合贝伐单抗（AteBev）被广泛用于晚期肝细胞癌（HCC）的一线治疗。然而，关于AteBev治疗后最佳用药顺序的证据有限。本研究旨在比较酪氨酸激酶抑制剂（TKIs）和durvalumab + tremelimumab （DurTre）在AteBev治疗后的治疗结果。患者和方法：总共有134例连续接受AteBev治疗晚期HCC的患者入组。回顾性比较TKIs （AteBev→TKI组）和DurTre （AteBev→DurTre组）的治疗结果。结果：AteBev→TKI组46例，Ate→DurTre组7例。AteBev→TKI组在二线治疗后的中位无进展生存期显著延长（3.6个月vs 0.94个月）。结论：从肿瘤学角度来看，AteBev治疗后的TKIs可能比DurTre更优。AteBev治疗后的tki需要仔细监测肝功能恶化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anticancer research 医学-肿瘤学

CiteScore

3.70

自引率

10.00%

发文量

566

审稿时长

2 months

期刊介绍： ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.