Jeayeon Park, Yun Bin Lee, Yunmi Ko, Youngsu Park, Hyunjae Shin, Moon Haeng Hur, Min Kyung Park, Dae-Won Lee, Eun Ju Cho, Kyung-Hun Lee, Jeong-Hoon Lee, Su Jong Yu, Tae-Yong Kim, Yoon Jun Kim, Tae-You Kim, Jung-Hwan Yoon
J Liver Cancer. 2024;24(1):81-91. Published online January 19, 2024
Background/Aim Atezolizumab plus bevacizumab and lenvatinib are currently available as first-line therapy for the treatment of unresectable hepatocellular carcinoma (HCC). However, comparative efficacy studies are still limited. This study aimed to investigate the effectiveness of these treatments in HCC patients with portal vein tumor thrombosis (PVTT).
Methods We retrospectively included patients who received either atezolizumab plus bevacizumab or lenvatinib as first-line systemic therapy for HCC with PVTT. Primary endpoint was overall survival (OS), and secondary endpoints included progressionfree survival (PFS) and disease control rate (DCR) determined by response evaluation criteria in solid tumors, version 1.1.
Results A total of 52 patients were included: 30 received atezolizumab plus bevacizumab and 22 received lenvatinib. The median follow-up duration was 6.4 months (interquartile range, 3.9-9.8). The median OS was 10.8 months (95% confidence interval [CI], 5.7 to not estimated) with atezolizumab plus bevacizumab and 5.8 months (95% CI, 4.8 to not estimated) with lenvatinib (P=0.26 by log-rank test). There was no statistically significant difference in OS (adjusted hazard ratio [aHR], 0.71; 95% CI, 0.34-1.49; P=0.37). The median PFS was similar (P=0.63 by log-rank test), with 4.1 months (95% CI, 3.3-7.7) for atezolizumab plus bevacizumab and 4.3 months (95% CI, 2.6-5.8) for lenvatinib (aHR, 0.93; 95% CI, 0.51-1.69; P=0.80). HRs were similar after inverse probability treatment weighting. The DCRs were 23.3% and 18.2% in patients receiving atezolizumab plus bevacizumab and lenvatinib, respectively (P=0.74).
Conclusion The effectiveness of atezolizumab plus bevacizumab and lenvatinib was comparable for the treatment of HCC with PVTT.
Citations
Citations to this article as recorded by
Role of Liver Function in the Multiparametric Assessment of Hepatocellular Carcinoma Fabio Melandro, Leonardo Centonze, Ciro Celsa, Simone Famularo, Davide Ghinolfi, Silvia Nardelli, Maria Pallozzi, Ludovico Abenavoli, Fabrizio Romano, Francesca Romana Ponziani, Francesco Paolo Russo, Quirino Lai Medicina.2026; 62(1): 138. CrossRef
Combined Transarterial Chemoembolization and External Beam Radiotherapy for Identifying Surgical Candidates for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: A Propensity Score–Weighted Analysis Sumin Lee, Jinhong Jung, Jonggi Choi, So Yeon Kim, Jin Hyoung Kim, Danbi Lee, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim, Han Chu Lee, Gi-Won Song, Jin-hong Park, Sang Min Yoon Cancer Research and Treatment.2026; 58(1): 275. CrossRef
Management strategies for advanced hepatocellular carcinoma with
portal vein tumor thrombosis Jeayeon Park, Su Jong Yu The Ewha Medical Journal.2025;[Epub] CrossRef
Case Report: Tumor lysis syndrome in advanced, massive hepatocellular carcinoma with main portal vein invasion following atezolizumab plus bevacizumab therapy Tien-Shin Chou, Chun-Feng Wu, Chih-Lang Lin, Chao-Wei Hsu Frontiers in Oncology.2025;[Epub] CrossRef
Locoregional therapy combined with targeted therapy and immunotherapy for hepatocellular carcinoma with portal vein tumor thrombosis: a systematic review and meta-analysis Mengjie Jiang, Chao Chen, Yujie Hu, Gang Lin, Huafeng Li Scientific Reports.2025;[Epub] CrossRef
Liver Resection versus Targeted Therapy Plus PD-1 Inhibitors in Hepatocellular Carcinoma with Type I-II Portal Vein Tumor Thrombus: A Comparative Study Liang Li, Zhenli Li, Yibing Zhang, Shuaishuai Zhu, Yuanzhi Ni, Lindi Xu, Shixing Yan, Yufu Tang Journal of Hepatocellular Carcinoma.2025; Volume 12: 2745. CrossRef
Prognostic Significance of Glypican-3 Expression in Hepatocellular Carcinoma Treated with Atezolizumab-Bevacizumab Ji Hoon Kim, Ji Won Han, Hee Sun Cho, Jeong Won Jang, Kwon Yong Tak, Pil Soo Sung Cancers.2025; 17(24): 3967. CrossRef
Portal vein tumor thrombosis in hepatocellular carcinoma patients: Is it the end? Walaa Abdelhamed, Hend Shousha, Mohamed El-Kassas Liver Research.2024;[Epub] CrossRef
Reappraisal of transarterial radioembolization for liver-confined hepatocellular carcinoma with portal vein tumor thrombosis: Editorial on “Transarterial radioembolization versus tyrosine kinase inhibitor in hepatocellular carcinoma with portal vein throm Jin Hyoung Kim, Gun Ha Kim, Dong Il Gwon Clinical and Molecular Hepatology.2024; 30(4): 659. CrossRef
Current perspectives on the pharmacological treatment of advanced
hepatocellular carcinoma: a narrative review Hye-Jin Yoo, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim The Ewha Medical Journal.2024;[Epub] CrossRef