Improved survival with second-line hepatic arterial infusion chemotherapy after atezolizumab-bevacizumab failure in hepatocellular carcinoma

BackgroundThere is no established second-line treatment for hepatocellular carcinoma (HCC) following atezolizumab-bevacizumab (ate-beva) failure. This study assessed the efficacy of hepatic arterial infusion chemotherapy (HAIC) as a salvage therapy by comparing survival outcomes and treatment respon...

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Main Authors: Ji Yeon Lee, Jaejun Lee, Suho Kim, Jae-sung Yoo, Ji Hoon Kim, Keungmo Yang, Ji Won Han, Jeong Won Jang, Jong Yong Choi, Seung Kew Yoon, Ho Jong Chun, Jung Suk Oh, Pil Soo Sung
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Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2024.1495321/full
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author Ji Yeon Lee
Jaejun Lee
Suho Kim
Jae-sung Yoo
Ji Hoon Kim
Keungmo Yang
Ji Won Han
Jeong Won Jang
Jong Yong Choi
Seung Kew Yoon
Ho Jong Chun
Jung Suk Oh
Pil Soo Sung
author_facet Ji Yeon Lee
Jaejun Lee
Suho Kim
Jae-sung Yoo
Ji Hoon Kim
Keungmo Yang
Ji Won Han
Jeong Won Jang
Jong Yong Choi
Seung Kew Yoon
Ho Jong Chun
Jung Suk Oh
Pil Soo Sung
author_sort Ji Yeon Lee
collection DOAJ
description BackgroundThere is no established second-line treatment for hepatocellular carcinoma (HCC) following atezolizumab-bevacizumab (ate-beva) failure. This study assessed the efficacy of hepatic arterial infusion chemotherapy (HAIC) as a salvage therapy by comparing survival outcomes and treatment responses between HAIC as a first-line treatment and as a second-line option after ate-beva failure.Materials and MethodsWe retrospectively analyzed 100 patients with advanced HCC treated with HAIC between March 2022 and July 2024. Patients were categorized into two groups: those who received HAIC as initial therapy (first-line HAIC group) and those who received HAIC following ate-beva failure (post-ate-beva group). Survival outcomes were assessed with Kaplan-Meier curves and log-rank tests, and factors associated with survival were identified through Cox regression analysis.ResultsThe post-ate-beva group exhibited longer overall survival (OS) (median OS 12.4 months) compared to the first-line HAIC group (median OS 6.8 months) (p = 0.073). Progression-free survival (PFS) was significantly superior in the post-ate-beva group (median PFS 8.2 months) compared to the first-line HAIC group (median PFS 3.1 months) (p = 0.018). The objective response rate was also notably higher in the post-ate-beva group than in the first-line HAIC group (35.3% vs. 18.1%, p = 0.031). In multivariate analysis, HAIC following ate-beva failure, compared to first-line HAIC, was significantly associated with favorable outcomes for both OS (p = 0.014) and PFS (p = 0.006).ConclusionThe superior survival outcomes and treatment responses observed in the post-ate-beva group suggest that HAIC may be an effective second-line treatment option for advanced HCC following ate-beva therapy failure. However, due to the retrospective nature and small sample size of the study, further prospective studies with larger patient populations are needed to strengthen the evidence.
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spelling doaj-art-25c06b72449d454486ae3b9ae0bb0d802025-08-20T02:39:27ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-12-011410.3389/fonc.2024.14953211495321Improved survival with second-line hepatic arterial infusion chemotherapy after atezolizumab-bevacizumab failure in hepatocellular carcinomaJi Yeon Lee0Jaejun Lee1Suho Kim2Jae-sung Yoo3Ji Hoon Kim4Keungmo Yang5Ji Won Han6Jeong Won Jang7Jong Yong Choi8Seung Kew Yoon9Ho Jong Chun10Jung Suk Oh11Pil Soo Sung12Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaSchool of Medicine, Kyungpook National University, Daegu, Republic of KoreaDivision of Hepatology, Department of Internal Medicine, Uijeongbu St Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaBackgroundThere is no established second-line treatment for hepatocellular carcinoma (HCC) following atezolizumab-bevacizumab (ate-beva) failure. This study assessed the efficacy of hepatic arterial infusion chemotherapy (HAIC) as a salvage therapy by comparing survival outcomes and treatment responses between HAIC as a first-line treatment and as a second-line option after ate-beva failure.Materials and MethodsWe retrospectively analyzed 100 patients with advanced HCC treated with HAIC between March 2022 and July 2024. Patients were categorized into two groups: those who received HAIC as initial therapy (first-line HAIC group) and those who received HAIC following ate-beva failure (post-ate-beva group). Survival outcomes were assessed with Kaplan-Meier curves and log-rank tests, and factors associated with survival were identified through Cox regression analysis.ResultsThe post-ate-beva group exhibited longer overall survival (OS) (median OS 12.4 months) compared to the first-line HAIC group (median OS 6.8 months) (p = 0.073). Progression-free survival (PFS) was significantly superior in the post-ate-beva group (median PFS 8.2 months) compared to the first-line HAIC group (median PFS 3.1 months) (p = 0.018). The objective response rate was also notably higher in the post-ate-beva group than in the first-line HAIC group (35.3% vs. 18.1%, p = 0.031). In multivariate analysis, HAIC following ate-beva failure, compared to first-line HAIC, was significantly associated with favorable outcomes for both OS (p = 0.014) and PFS (p = 0.006).ConclusionThe superior survival outcomes and treatment responses observed in the post-ate-beva group suggest that HAIC may be an effective second-line treatment option for advanced HCC following ate-beva therapy failure. However, due to the retrospective nature and small sample size of the study, further prospective studies with larger patient populations are needed to strengthen the evidence.https://www.frontiersin.org/articles/10.3389/fonc.2024.1495321/fullcarcinomahepatocellularhepatic arterial infusion chemotherapyatezolizumabbevacizumabimmunogenic cell death
spellingShingle Ji Yeon Lee
Jaejun Lee
Suho Kim
Jae-sung Yoo
Ji Hoon Kim
Keungmo Yang
Ji Won Han
Jeong Won Jang
Jong Yong Choi
Seung Kew Yoon
Ho Jong Chun
Jung Suk Oh
Pil Soo Sung
Improved survival with second-line hepatic arterial infusion chemotherapy after atezolizumab-bevacizumab failure in hepatocellular carcinoma
Frontiers in Oncology
carcinoma
hepatocellular
hepatic arterial infusion chemotherapy
atezolizumab
bevacizumab
immunogenic cell death
title Improved survival with second-line hepatic arterial infusion chemotherapy after atezolizumab-bevacizumab failure in hepatocellular carcinoma
title_full Improved survival with second-line hepatic arterial infusion chemotherapy after atezolizumab-bevacizumab failure in hepatocellular carcinoma
title_fullStr Improved survival with second-line hepatic arterial infusion chemotherapy after atezolizumab-bevacizumab failure in hepatocellular carcinoma
title_full_unstemmed Improved survival with second-line hepatic arterial infusion chemotherapy after atezolizumab-bevacizumab failure in hepatocellular carcinoma
title_short Improved survival with second-line hepatic arterial infusion chemotherapy after atezolizumab-bevacizumab failure in hepatocellular carcinoma
title_sort improved survival with second line hepatic arterial infusion chemotherapy after atezolizumab bevacizumab failure in hepatocellular carcinoma
topic carcinoma
hepatocellular
hepatic arterial infusion chemotherapy
atezolizumab
bevacizumab
immunogenic cell death
url https://www.frontiersin.org/articles/10.3389/fonc.2024.1495321/full
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