文章：

乐伐替尼加剧肝细胞癌患者骨骼肌质量下降，而阿特珠单抗联合贝伐珠单抗则无此影响

Lenvatinib Exacerbates the Decrease in Skeletal Muscle Mass in Patients with Hepatocellular Carcinoma, Whereas Atezolizumab Plus Bevacizumab Does Not

原文发布日期：19 January 2024

DOI: 10.3390/cancers16020442

类型: Article

开放获取: 是

英文摘要：

This study aimed to evaluate chronological changes in skeletal muscle index (SMI), subcutaneous and visceral adipose tissue indices (SATI and VATI), AFP, PIVKA-II, and ALBI scores during atezolizumab plus bevacizumab (AB) or lenvatinib (LEN) treatment for hepatocellular carcinoma (HCC) and the effect of these changes on survival. A total of 94 patients with HCC (37 were on AB and 57 on LEN) were enrolled. SMI, SATI, VATI, AFP, PIVKA-II, and ALBI scores were analyzed at the time of the treatment introduction (Intro), 3 months after the introduction (3M), at drug discontinuation (End), and the last observational time (Last). The differences between chronological changes were analyzed using the Wilcoxon paired test. The independent predictors for survival and the changes in SMI during AB or LEN (c-SMI%) were analyzed using the Cox proportional hazards model treating all these factors as time-varying covariates and the analysis of covariance, respectively. SMI in the AB group was maintained over time (42.9–44.0–40.6–44.2 cm2/m2), whereas that in the LEN group significantly decreased during the Intro–3M (p< 0.05) and 3M–End (p< 0.05) period (46.5–45.1–42.8–42.1 cm2/m2). SMI (p< 0.001) was an independent predictor for survival together with AFP (p= 0.004) and ALBI score (p< 0.001). Drug choice (AB or LEN;p= 0.038) and PIVKA-II (p< 0.001) were extracted as independent predictors for c-SMI%. AB treatment was significantly superior to LEN in terms of maintaining skeletal muscle, which is an independent predictor for survival.

摘要翻译： 

本研究旨在评估肝细胞癌（HCC）患者接受阿特珠单抗联合贝伐珠单抗（AB）或仑伐替尼（LEN）治疗期间，骨骼肌指数（SMI）、皮下及内脏脂肪组织指数（SATI和VATI）、甲胎蛋白（AFP）、异常凝血酶原（PIVKA-II）及ALBI评分的时序性变化，并探讨这些变化对生存期的影响。共纳入94例HCC患者（其中37例接受AB治疗，57例接受LEN治疗）。分别在治疗开始时（Intro）、开始后3个月（3M）、停药时（End）及末次观察时间（Last）分析SMI、SATI、VATI、AFP、PIVKA-II及ALBI评分。采用Wilcoxon配对检验分析时序变化的差异。通过将全部因素视为时变协变量的Cox比例风险模型和协方差分析，分别评估生存期的独立预测因子以及AB或LEN治疗期间SMI的变化率（c-SMI%）。AB组的SMI随时间推移保持稳定（42.9–44.0–40.6–44.2 cm²/m²），而LEN组的SMI在Intro–3M（p<0.05）和3M–End（p<0.05）期间显著下降（46.5–45.1–42.8–42.1 cm²/m²）。SMI（p<0.001）与AFP（p=0.004）及ALBI评分（p<0.001）共同被确定为生存期的独立预测因子。药物选择（AB或LEN；p=0.038）和PIVKA-II（p<0.001）被提取为c-SMI%的独立预测因子。在维持骨骼肌方面，AB治疗显著优于LEN，而骨骼肌是生存期的重要独立预测因子。

原文链接：

Lenvatinib Exacerbates the Decrease in Skeletal Muscle Mass in Patients with Hepatocellular Carcinoma, Whereas Atezolizumab Plus Bevacizumab Does Not