This retrospective multicenter study analyzed 244 patients with unresectable hepatocellular carcinoma treated with lenvatinib (LEN) and atezolizumab + bevacizumab (Atezo + Bev) to examine the characteristics, treatment courses, and prognoses. The cases of patients who could achieve HCC downstaging from Barcelona Clinic Liver Cancer (BCLC) stage B or C to A or zero indicated the need for conversion therapy. The patients’ prognoses with and without conversion therapy were compared. Of the 244 patients, 12 (4.9%) underwent conversion therapy, six out of 131 (4.6%) were treated with LEN, and six out of 113 (5.3%) were treated with Atezo + Bev. Eleven patients (91.7%) with a modified albumin bilirubin (mALBI) grade 1 or 2a and BCLC-B stage showed significantly higher rates of transition during conversion therapy (p< 0.05). The patients undergoing conversion therapy had a significantly longer median overall survival rate than those receiving chemotherapy alone (1208 [1064–NA] vs. 569 [466–704] days,p< 0.01). A comparison of the patients who achieved a partial response with and without conversion was evaluated using propensity score matching to reduce the confounding factors, showing a significant survival benefit in the conversion group (1208 [1064–NA] vs. 665 days,p< 0.01). Among the patients with u-HCC who were treated with LEN and Atezo + Bev, those with mALBI 1 + 2a and BCLC-B were likely to achieve conversion therapy with downstaging.
这项回顾性多中心研究分析了244例接受乐伐替尼（LEN）与阿特珠单抗+贝伐珠单抗（Atezo+Bev）治疗的不可切除肝细胞癌患者，旨在探讨其临床特征、治疗过程及预后。研究重点关注了通过降期治疗从巴塞罗那临床肝癌分期（BCLC）B或C期转为A期或零期的病例，揭示了转化治疗的必要性。研究对比了接受与未接受转化治疗患者的预后差异。在244例患者中，12例（4.9%）接受了转化治疗，其中LEN治疗组131例中有6例（4.6%），Atezo+Bev治疗组113例中有6例（5.3%）。11例（91.7%）改良白蛋白-胆红素分级（mALBI）为1级或2a级且处于BCLC-B期的患者在转化治疗期间实现分期降级的比例显著更高（p<0.05）。接受转化治疗患者的中位总生存期显著长于仅接受化疗的患者（1208 [1064–NA]天 vs. 569 [466–704]天，p<0.01）。通过倾向评分匹配法对达到部分缓解的病例进行组间比较以控制混杂因素，结果显示转化治疗组具有显著的生存获益（1208 [1064–NA]天 vs. 665天，p<0.01）。在接受LEN和Atezo+Bev治疗的不可切除肝细胞癌患者中，mALBI分级1+2a级且处于BCLC-B期的患者更可能通过降期治疗实现转化治疗。
肿瘤(癌症)患者之家