Impact of older age in patients receiving atezolizumab and bevacizumab for hepatocellular carcinoma
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Impact of older age in patients receiving atezolizumab and bevacizumab for hepatocellular carcinoma. / Vithayathil, Mathew; D'Alessio, Antonio; Fulgenzi, Claudia Angela Maria; Nishida, Naoshi; Schönlein, Martin; von Felden, Johann; Schulze, Kornelius; Wege, Henning; Saeed, Anwaar; Wietharn, Brooke; Hildebrand, Hannah; Wu, Linda; Ang, Celina; Marron, Thomas U; Weinmann, Arndt; Galle, Peter R; Bettinger, Dominik; Bengsch, Bertram; Vogel, Arndt; Balcar, Lorenz; Scheiner, Bernhard; Lee, Pei-Chang; Huang, Yi-Hsiang; Amara, Suneetha; Muzaffar, Mahvish; Naqash, Abdul Rafeh; Cammarota, Antonella; Personeni, Nicola; Pressiani, Tiziana; Pinter, Matthias; Cortellini, Alessio; Kudo, Masatoshi; Rimassa, Lorenza; Pinato, David J; Sharma, Rohini.
in: LIVER INT, Jahrgang 42, Nr. 11, 11.2022, S. 2538-2547.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Impact of older age in patients receiving atezolizumab and bevacizumab for hepatocellular carcinoma
AU - Vithayathil, Mathew
AU - D'Alessio, Antonio
AU - Fulgenzi, Claudia Angela Maria
AU - Nishida, Naoshi
AU - Schönlein, Martin
AU - von Felden, Johann
AU - Schulze, Kornelius
AU - Wege, Henning
AU - Saeed, Anwaar
AU - Wietharn, Brooke
AU - Hildebrand, Hannah
AU - Wu, Linda
AU - Ang, Celina
AU - Marron, Thomas U
AU - Weinmann, Arndt
AU - Galle, Peter R
AU - Bettinger, Dominik
AU - Bengsch, Bertram
AU - Vogel, Arndt
AU - Balcar, Lorenz
AU - Scheiner, Bernhard
AU - Lee, Pei-Chang
AU - Huang, Yi-Hsiang
AU - Amara, Suneetha
AU - Muzaffar, Mahvish
AU - Naqash, Abdul Rafeh
AU - Cammarota, Antonella
AU - Personeni, Nicola
AU - Pressiani, Tiziana
AU - Pinter, Matthias
AU - Cortellini, Alessio
AU - Kudo, Masatoshi
AU - Rimassa, Lorenza
AU - Pinato, David J
AU - Sharma, Rohini
N1 - This article is protected by copyright. All rights reserved.
PY - 2022/11
Y1 - 2022/11
N2 - BACKGROUND AND AIMS: Combination atezolizumab/bevacizumab is the gold standard for first line-treatment of unresectable hepatocellular carcinoma (HCC). Our study investigated the efficacy and safety of combination therapy in older patients with HCC.METHODS: 191 consecutive patients from eight centres receiving atezolizumab and bevacizumab were included. Overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and disease control rate (DCR) defined by RECIST v1.1 were measured in older (age≥65 years) and younger (age<65 years) age patients. Treatment-related adverse events (trAEs) were evaluated.RESULTS: The elderly (n=116) had higher rates of non-alcoholic fatty liver disease (19.8% vs. 2.7%; p<0.001), presenting with smaller tumours (6.2cm vs 7.9cm, p=0.02) with less portal vein thrombosis (31.9 vs. 54.7%, p=0.002), with fewer patients presenting with BCLC-C stage disease (50.9 vs. 74.3%, p=0.002). There was no significant difference in OS (median 14.9 vs. 15.1 months; HR 1.15, 95% CI 0.65-2.02 p=0.63) and PFS (median 7.1 vs. 5.5 months; HR 1.11, 95% CI 0.54-1.92; p=0.72) between older age and younger age. Older patients had similar ORR (27.6% vs. 20.0%; p=0.27) and DCR (77.5% vs. 66.1%; p=0.11) compared to younger patients. Atezolizumab-related (40.5% vs. 48.0%; p=0.31) and bevacizumab-related (44.8% vs. 41.3%; p=0.63) trAEs were comparable between groups. Rates of grade ≥3 trAEs and toxicity-related treatment discontinuation were similar between older and younger age patients. Patients 75 years and older had similar survival and safety outcomes compared to younger patients.CONCLUSIONS: Atezolizumab and bevacizumab therapy is associated with comparable efficacy and tolerability in older age patients with unresectable HCC.
AB - BACKGROUND AND AIMS: Combination atezolizumab/bevacizumab is the gold standard for first line-treatment of unresectable hepatocellular carcinoma (HCC). Our study investigated the efficacy and safety of combination therapy in older patients with HCC.METHODS: 191 consecutive patients from eight centres receiving atezolizumab and bevacizumab were included. Overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and disease control rate (DCR) defined by RECIST v1.1 were measured in older (age≥65 years) and younger (age<65 years) age patients. Treatment-related adverse events (trAEs) were evaluated.RESULTS: The elderly (n=116) had higher rates of non-alcoholic fatty liver disease (19.8% vs. 2.7%; p<0.001), presenting with smaller tumours (6.2cm vs 7.9cm, p=0.02) with less portal vein thrombosis (31.9 vs. 54.7%, p=0.002), with fewer patients presenting with BCLC-C stage disease (50.9 vs. 74.3%, p=0.002). There was no significant difference in OS (median 14.9 vs. 15.1 months; HR 1.15, 95% CI 0.65-2.02 p=0.63) and PFS (median 7.1 vs. 5.5 months; HR 1.11, 95% CI 0.54-1.92; p=0.72) between older age and younger age. Older patients had similar ORR (27.6% vs. 20.0%; p=0.27) and DCR (77.5% vs. 66.1%; p=0.11) compared to younger patients. Atezolizumab-related (40.5% vs. 48.0%; p=0.31) and bevacizumab-related (44.8% vs. 41.3%; p=0.63) trAEs were comparable between groups. Rates of grade ≥3 trAEs and toxicity-related treatment discontinuation were similar between older and younger age patients. Patients 75 years and older had similar survival and safety outcomes compared to younger patients.CONCLUSIONS: Atezolizumab and bevacizumab therapy is associated with comparable efficacy and tolerability in older age patients with unresectable HCC.
U2 - 10.1111/liv.15405
DO - 10.1111/liv.15405
M3 - SCORING: Journal article
C2 - 35986902
VL - 42
SP - 2538
EP - 2547
JO - LIVER INT
JF - LIVER INT
SN - 1478-3223
IS - 11
ER -
