接受 Atezolizumab 加贝伐单抗治疗后具有持久部分缓解或持久稳定疾病的肝细胞癌患者的临床结果和组织学结果。
Clinical Outcomes and Histologic Findings of Patients With Hepatocellular Carcinoma With Durable Partial Response or Durable Stable Disease After Receiving Atezolizumab Plus Bevacizumab.
发表日期：2024 Aug 28
作者：
Ying-Chun Shen, Tsung-Hao Liu, Alan Nicholas, Akihiko Soyama, Chang-Tsu Yuan, Tse-Ching Chen, Susumu Eguchi, Tomoharu Yoshizumi, Shinji Itoh, Noriaki Nakamura, Hisashi Kosaka, Masaki Kaibori, Takamichi Ishii, Etsuro Hatano, Chikara Ogawa, Atsushi Naganuma, Satoru Kakizaki, Chih-Hsien Cheng, Po-Ting Lin, Yung-Yeh Su, Chien-Huai Chuang, Li-Chun Lu, Chi-Jung Wu, Hung-Wei Wang, Kun-Ming Rau, Chih-Hung Hsu, Shi-Ming Lin, Yi-Hsiang Huang, Sairy Hernandez, Richard S Finn, Masatoshi Kudo, Ann-Lii Cheng
来源：
MEDICINE & SCIENCE IN SPORTS & EXERCISE
摘要：
持久部分缓解 (PR) 和持久稳定疾病 (SD) 常见于接受阿特珠单抗联合贝伐单抗 (atezo-bev) 治疗的肝细胞癌 (HCC) 患者。本研究调查了这些患者的结果以及残留肿瘤的组织病理学。对 IMbrave150 研究的 atezo-bev 组进行了分析。根据 RECIST v1.1，PR 或 SD 持续超过 6 个月被定义为持久。为了进行组织学分析，对一组来自日本和台湾的真实世界患者进行了研究，这些患者在atezo-bev后接受了残余肿瘤切除术。在IMbrave150研究中，72例PR中的56例（77.8%）和41例（28.5%） 144 个 SD 中的 1 个被认为是耐用的。持久 PR 患者的中位总生存期无法估计，而持久 SD 患者的中位总生存期为 23.7 个月。持久 PR 患者的中位无进展生存期为 23.2 个月，持久 SD 患者的中位无进展生存期为 13.2 个月。在现实世界中，接受 atezo-bev 治疗的 32 名患者（23 名 PR 和 9 名 SD）总共切除了 38 个肿瘤。 PR 肿瘤的病理完全缓解 (PCR) 比 SD 肿瘤更常见 (57.7% vs 16.7%，P = 0.034)。 PCR 率与从atezo-bev 开始到切除的时间相关，对于开始atezo-bev 后8 个月以上切除的PR 肿瘤，PCR 率为55.6%（9 例中的5 例），该时间实际上与IMbrave150 使用的持久PR 定义相对应。我们没有发现可靠的放射学特征来预测残留肿瘤的 PCR。atezo-bev 组的持久性 PR 患者表现出良好的结果，这可能部分是由于 PCR 病变发生率高。 PCR病变的早期识别可能有助于后续的治疗决策。
Durable partial response (PR) and durable stable disease (SD) are often seen in patients with hepatocellular carcinoma (HCC) receiving atezolizumab plus bevacizumab (atezo-bev). This study investigates the outcome of these patients and the histopathology of the residual tumors.The IMbrave150 study's atezo-bev group was analyzed. PR or SD per RECIST v1.1 lasting more than 6 months was defined as durable. For histologic analysis, a comparable real-world group of patients from Japan and Taiwan who had undergone resection of residual tumors after atezo-bev was investigated.In the IMbrave150 study, 56 (77.8%) of the 72 PRs and 41 (28.5%) of the 144 SDs were considered durable. The median overall survival was not estimable for patients with durable PR and 23.7 months for those with durable SD. The median progression-free survival was 23.2 months for patients with durable PR and 13.2 months for those with durable SD. In the real-world setting, a total of 38 tumors were resected from 32 patients (23 PRs and nine SDs) receiving atezo-bev. Pathologic complete responses (PCRs) were more frequent in PR tumors than SD tumors (57.7% v 16.7%, P = .034). PCR rate correlated with time from atezo-bev initiation to resection and was 55.6% (5 of 9) for PR tumors resected beyond 8 months after starting atezo-bev, a time practically corresponding to the durable PR definition used for IMbrave150. We found no reliable radiologic features to predict PCR of the residual tumors.Durable PR patients from the atezo-bev group showed a favorable outcome, which may be partly explained by the high rate of PCR lesions. Early recognition of PCR lesions may help subsequent treatment decision.