Comparison of Efficacy and Safety of Atezolizumab Plus Bevacizumab and Lenvatinib as First-Line Therapy for Unresectable Hepatocellular Carcinoma: A Propensity Score Matching Analysis

Takashi Niizeki, Takayuki Tokunaga, Yuko Takami, Yoshiyuki Wada, Masaru Harada, Michihiko Shibata, Kazuhiko Nakao, Ryu Sasaki, Fumihito Hirai, Satoshi Shakado, Tomoharu Yoshizumi, Shinji Itoh, Hiroshi Yatsuhashi, Shigemune Bekki, Akio Ido, Seiichi Mawatari, Koichi Honda, Rie Sugimoto, Takeshi Senju, Hirokazu TakahashiTakuya Kuwashiro, Tatsuji Maeshiro, Makoto Nakamuta, Yoshifusa Aratake, Tsutomu Yamashita, Yuichiro Otsuka, Shuichi Matsumoto, Tetsuro Sohda, Shigeo Shimose, Kenta Murotani, Yasuhito Tanaka

Research output: Contribution to journalArticlepeer-review

Abstract

Background: A comparison between atezolizumab plus bevacizumab (ATEZO/BEVA) and lenvatinib (LEN) for the treatment of hepatocellular carcinoma (HCC) remains unclear. Objective: This study aimed to compare the therapeutic effects and safety of ATEZO/BEVA and LEN as first-line therapies for HCC. Patients and Methods: This study was a retrospective analysis of 810 patients with HCC who underwent ATEZO/BEVA (n = 186) or LEN (n = 624) as first-line systemic therapy between March 2018 to March 2022 at 14 facilities. After propensity score matching, 304 patients (ATEZO/BEVA group: n = 152; LEN group: n = 152) were analyzed. Results: After propensity score matching, although there was no significant difference in objective response rates (ORRs) between the ATEZO/BEVA and LEN groups (ORR 44.8% vs. 46.7%, p = 0.644), the median progression-free survival (PFS) and median overall survival (OS) in the ATEZO/BEVA group were significantly higher than those in the LEN group (median PFS: 8.3 months vs. 6.0 months, p = 0.005; median OS: not reached vs. 20.2 months, p = 0.039). The rates of appetite loss, fatigue, and proteinuria of grade 3 or higher in the ATEZO/BEVA group were lower than those in the LEN group. However, the rate of bleeding of grade 3 or higher in the ATEZO/BEVA group was higher than that in the LEN group. The conversion rate was higher in the ATEZO/BEVA group than that in the LEN group (8.6% vs. 1.9%, p = 0.007). Conclusions: ATEZO/BEVA showed superiority to LEN in terms of prognosis and conversion rate as first-line therapy. Moreover, ATEZO/BEVA had a lower rate of severe adverse events, except for bleeding, than LEN.

Original languageEnglish
Pages (from-to)643-653
Number of pages11
JournalTargeted Oncology
Volume17
Issue number6
DOIs
Publication statusPublished - Nov 2022

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research
  • Pharmacology (medical)

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