Real-world data regarding treatment with atezolizumab plus bevacizumab in high-risk patients with advanced HCC are lacking. In this multicenter retrospective cohort study, a total of 215 patients with advanced HCC received atezolizumab plus bevacizumab treatment at four tertiary hospitals. High-risk patients were those with grade Vp4 portal vein thrombus, bile duct invasion, or more than 50% liver infiltration. In total, 98 (45.6%) were the high-risk population, 186 (86.5%) were considered to be Child–Pugh class A, and 128 (59.5%) had previously received neoadjuvant or concomitant radiation treatment. Median overall survival (OS) was 11.25 months (95% CI, 9.50–13.10), and the median progression-free survival (PFS) was 8.00 months (95% CI, 6.82–9.18). In the high-risk population, the median OS was 10 months (95% CI, 8.19–11.82) and the median PFS was 6.50 months (95% CI, 3.93–9.08). In the high-risk population, multivariate analysis indicated that radiation therapy and lower ALBI grade were associated with better OS and PFS. A total of 177 (82.3%) patients experienced adverse events of any grade, the most common being proteinuria (23.7%). Atezolizumab plus bevacizumab treatment showed consistent efficacy and tolerability in both the total and high-risk population. Radiation therapy combined with atezolizumab plus bevacizumab treatment might be helpful to improve PFS and OS in high-risk populations.
目前缺乏关于阿替利珠单抗联合贝伐珠单抗治疗高危晚期肝细胞癌患者的真实世界数据。本研究为一项多中心回顾性队列研究，共纳入来自四家三级医院的215例接受阿替利珠单抗联合贝伐珠单抗治疗的晚期肝细胞癌患者。高危患者定义为存在Vp4级门静脉癌栓、胆管侵犯或肝脏浸润超过50%的患者。其中98例（45.6%）属于高危人群，186例（86.5%）为Child-Pugh A级，128例（59.5%）曾接受新辅助或同期放射治疗。总体中位总生存期为11.25个月（95% CI，9.50-13.10），中位无进展生存期为8.00个月（95% CI，6.82-9.18）。在高危人群中，中位总生存期为10个月（95% CI，8.19-11.82），中位无进展生存期为6.50个月（95% CI，3.93-9.08）。多变量分析显示，在高危人群中，放射治疗和较低的ALBI分级与更好的总生存期和无进展生存期相关。共177例（82.3%）患者出现各级不良事件，最常见的是蛋白尿（23.7%）。阿替利珠单抗联合贝伐珠单抗治疗在总体人群和高危人群中均表现出稳定的疗效和耐受性。放射治疗联合阿替利珠单抗与贝伐珠单抗治疗可能有助于改善高危人群的无进展生存期和总生存期。
肿瘤(癌症)患者之家