Toshifumi Tada1,2, Takashi Kumada3, Atsushi Hiraoka4, Masashi Hirooka5, Kazuya Kariyama6, Joji Tani7, Masanori Atsukawa8, Koichi Takaguchi9, Ei Itobayashi10, Shinya Fukunishi11, Kunihiko Tsuji12, Toru Ishikawa13, Kazuto Tajiri14, Hironori Ochi15, Satoshi Yasuda16, Hidenori Toyoda16, Chikara Ogawa17, Takashi Nishimura2, Takeshi Hatanaka18, Satoru Kakizaki19, Noritomo Shimada20, Kazuhito Kawata21, Takaaki Tanaka4, Hideko Ohama11, Kazuhiro Nouso6, Asahiro Morishita7, Akemi Tsutsui9, Takuya Nagano9, Norio Itokawa8, Tomomi Okubo8, Taeang Arai8, Michitaka Imai13, Atsushi Naganuma22, Yohei Koizumi5, Shinichiro Nakamura1, Kouji Joko15, Hiroko Iijima2, Yoichi Hiasa5. 1. Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan. 2. Department of Internal medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan. 3. Department of Nursing, Gifu Kyoritsu University, Japan. 4. Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan. 5. Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan. 6. Department of Gastroenterology, Okayama City Hospital, Okayama, Japan. 7. Department of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan. 8. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan. 9. Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan. 10. Department of Gastroenterology, Asahi General Hospital, Asahi, Japan. 11. Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan. 12. Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan. 13. Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan. 14. Department of Gastroenterology, Toyama University Hospital, Toyama, Japan. 15. Center for Liver-Biliary-Pancreatic Disease, Matsuyama Red Cross Hospital, Matsuyama, Japan. 16. Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Japan. 17. Department of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Japan. 18. Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan. 19. Department of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan. 20. Division of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Japan. 21. Department of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan. 22. Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.
Abstract
AIM: The safety and efficacy of atezolizumab plus bevacizumab (Atez/Bev) in elderly patients with unresectable hepatocellular carcinoma (HCC) have not been sufficiently investigated. METHODS: A total of 317 patients with HCC treated with Atez/Bev were studied. We compared the survival and frequency of adverse events in elderly versus non-elderly patients with HCC who were treated with Atez/Bev using an analysis of inverse probability weighting (IPW). RESULTS: Univariate analysis adjusted with IPW showed that being elderly is not associated with worse overall or progression-free survival (hazard ratio [HR], 1.239; 95% confidence interval [CI], 0.640-2.399; p = 0.526 and HR, 1.256; 95% CI, 0.871-1.811; p = 0.223, respectively). Regarding treatment-related adverse events, any grade of fatigue, proteinuria, decreased appetite, hypertension, and liver injury occurred in ≥10% of patients. There were no significant differences in treatment-related adverse events between the elderly and non-elderly groups. In a subgroup analysis of elderly patients aged 75-79, 80-84, or ≥ 85 years, there were no significant differences in cumulative overall or progression-free survival among these age groups (p = 0.960 and 0.566, respectively). In addition, there were no significant differences in treatment-related adverse events among these three age groups, except for proteinuria of any grade. In a subgroup analysis of patients treated with Atez/Bev as first-line systemic therapy, there were no significant differences in cumulative overall or progression-free survival between the elderly and non-elderly groups (p = 0.728 and 0.805, respectively). CONCLUSIONS: Atez/Bev can be used efficaciously and safely in spite of age in patients with unresectable HCC.
AIM: The safety and efficacy of atezolizumab plus bevacizumab (Atez/Bev) in elderly patients with unresectable hepatocellular carcinoma (HCC) have not been sufficiently investigated. METHODS: A total of 317 patients with HCC treated with Atez/Bev were studied. We compared the survival and frequency of adverse events in elderly versus non-elderly patients with HCC who were treated with Atez/Bev using an analysis of inverse probability weighting (IPW). RESULTS: Univariate analysis adjusted with IPW showed that being elderly is not associated with worse overall or progression-free survival (hazard ratio [HR], 1.239; 95% confidence interval [CI], 0.640-2.399; p = 0.526 and HR, 1.256; 95% CI, 0.871-1.811; p = 0.223, respectively). Regarding treatment-related adverse events, any grade of fatigue, proteinuria, decreased appetite, hypertension, and liver injury occurred in ≥10% of patients. There were no significant differences in treatment-related adverse events between the elderly and non-elderly groups. In a subgroup analysis of elderly patients aged 75-79, 80-84, or ≥ 85 years, there were no significant differences in cumulative overall or progression-free survival among these age groups (p = 0.960 and 0.566, respectively). In addition, there were no significant differences in treatment-related adverse events among these three age groups, except for proteinuria of any grade. In a subgroup analysis of patients treated with Atez/Bev as first-line systemic therapy, there were no significant differences in cumulative overall or progression-free survival between the elderly and non-elderly groups (p = 0.728 and 0.805, respectively). CONCLUSIONS: Atez/Bev can be used efficaciously and safely in spite of age in patients with unresectable HCC.
Authors: Ghassan K Abou-Alfa; Tim Meyer; Ann-Lii Cheng; Anthony B El-Khoueiry; Lorenza Rimassa; Baek-Yeol Ryoo; Irfan Cicin; Philippe Merle; YenHsun Chen; Joong-Won Park; Jean-Frederic Blanc; Luigi Bolondi; Heinz-Josef Klümpen; Stephen L Chan; Vittorina Zagonel; Tiziana Pressiani; Min-Hee Ryu; Alan P Venook; Colin Hessel; Anne E Borgman-Hagey; Gisela Schwab; Robin K Kelley Journal: N Engl J Med Date: 2018-07-05 Impact factor: 91.245
Authors: Josep M Llovet; Sergio Ricci; Vincenzo Mazzaferro; Philip Hilgard; Edward Gane; Jean-Frédéric Blanc; Andre Cosme de Oliveira; Armando Santoro; Jean-Luc Raoul; Alejandro Forner; Myron Schwartz; Camillo Porta; Stefan Zeuzem; Luigi Bolondi; Tim F Greten; Peter R Galle; Jean-François Seitz; Ivan Borbath; Dieter Häussinger; Tom Giannaris; Minghua Shan; Marius Moscovici; Dimitris Voliotis; Jordi Bruix Journal: N Engl J Med Date: 2008-07-24 Impact factor: 91.245
Authors: Tomi Akinyemiju; Semaw Abera; Muktar Ahmed; Noore Alam; Mulubirhan Assefa Alemayohu; Christine Allen; Rajaa Al-Raddadi; Nelson Alvis-Guzman; Yaw Amoako; Al Artaman; Tadesse Awoke Ayele; Aleksandra Barac; Isabela Bensenor; Adugnaw Berhane; Zulfiqar Bhutta; Jacqueline Castillo-Rivas; Abdulaal Chitheer; Jee-Young Choi; Benjamin Cowie; Lalit Dandona; Rakhi Dandona; Subhojit Dey; Daniel Dicker; Huyen Phuc; Donatus U. Ekwueme; Maysaa El Sayed Zaki; Florian Fischer; Thomas Fürst; Jamie Hancock; Simon I. Hay; Peter Hotez; Sun Ha Jee; Amir Kasaeian; Yousef Khader; Young-Ho Khang; Anil Kumar; Michael Kutz; Heidi Larson; Alan Lopez; Raimundas Lunevicius; Reza Malekzadeh; Colm McAlinden; Toni Meier; Walter Mendoza; Ali Mokdad; Maziar Moradi-Lakeh; Gabriele Nagel; Quyen Nguyen; Grant Nguyen; Felix Ogbo; George Patton; David M. Pereira; Farshad Pourmalek; Mostafa Qorbani; Amir Radfar; Gholamreza Roshandel; Joshua A Salomon; Juan Sanabria; Benn Sartorius; Maheswar Satpathy; Monika Sawhney; Sadaf Sepanlou; Katya Shackelford; Hirbo Shore; Jiandong Sun; Desalegn Tadese Mengistu; Roman Topór-Mądry; Bach Tran; Vasiliy Vlassov; Stein Emil Vollset; Theo Vos; Tolassa Wakayo; Elisabete Weiderpass; Andrea Werdecker; Naohiro Yonemoto; Mustafa Younis; Chuanhua Yu; Zoubida Zaidi; Liguo Zhu; Christopher J. L. Murray; Mohsen Naghavi; Christina Fitzmaurice Journal: JAMA Oncol Date: 2017-12-01 Impact factor: 31.777