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THE KOREAN LIVER CANCER ASSOCIATION
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Original Article
- Downstaging with atezolizumab-bevacizumab: a case series
- Anand V. Kulkarni, Parthasarathy Kumaraswamy, Balachandran Menon, Anuradha Sekaran, Anuhya Rambhatla, Sowmya Iyengar, Manasa Alla, Shantan Venishetty, Sumana Kolar Ramachandra, Giri V. Premkumar, Mithun Sharma, P. Nagaraja Rao, Duvvur Nageshwar Reddy, Amit G. Singal
- J Liver Cancer. 2024;24(2):224-233. Published online May 27, 2024
- DOI: https://doi.org/10.17998/jlc.2024.05.12
- 9,968 Views
- 321 Downloads
- 13 Web of Science
- 15 Citations
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Abstract
PDF
Supplementary Material - Backgrounds/Aims
Hepatocellular carcinoma (HCC) is generally diagnosed at an advanced stage, which limits curative treatment options for these patients. Locoregional therapy (LRT) is the standard approach to bridge and downstage unresectable HCC for liver transplantation (LT). Atezolizumab-bevacizumab (atezo-bev) can induce objective responses in nearly one-third of patients; however, the role and outcomes of downstaging using atezo-bev remains unknown.
Methods
In this retrospective single-center study, we included consecutive patients between November 2020 and August 2023, who received atezo-bev with or without LRT and were subsequently considered for resection/LT after downstaging.
Results
Of the 115 patients who received atezo-bev, 12 patients (10.4%) achieved complete or partial response and were willing to undergo LT; they (age, 58.5 years; women, 17%; Barcelona Clinic Liver Cancer stage system B/C, 5/7) had received 3-12 cycles of atezo- bev, and four of them had received prior LRT. Three patients died before LT, while three were awaiting LT. Six patients underwent curative therapies: four underwent living donor LT after a median of 79.5 days (range, 54-114) following the last atezo-bev dose, one underwent deceased donor LT 38 days after the last dose, and one underwent resection. All but one patient had complete pathologic response with no viable HCC. Three patients experienced wound healing complications, and one required re-exploration and succumbed to sepsis. After a median follow-up of 10 months (range, 4-30), none of the alive patients developed HCC recurrence or graft rejection.
Conclusions
Surgical therapy, including LT, is possible after atezo-bev therapy in well-selected patients after downstaging. -
Citations
Citations to this article as recorded by
- Variceal Bleeding Due to Single-tremelimumab Regular-interval Durvalumab: Immunotherapy Induced or Cirrhosis Driven?
Vamshi K. Ankam, Srujana Priya, Arif M. Khan, Manu Tandon, Mithun Sharma, Padaki N. Rao, Duvvur N. Reddy, Anand V. Kulkarni
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Review Article
- Liquid biopsy for early detection and therapeutic monitoring of hepatocellular carcinoma
- Eun-Ji Choi, Young-Joon Kim
- J Liver Cancer. 2022;22(2):103-114. Published online September 22, 2022
- DOI: https://doi.org/10.17998/jlc.2022.09.08
- 20,840 Views
- 255 Downloads
- 19 Citations
-
Abstract
PDFSupplementary Material
- Advances in our knowledge of the molecular characteristics of hepatocellular carcinoma (HCC) have enabled significant progress in the detection and therapeutic prediction of HCC. As a non-invasive alternative to tissue biopsy, liquid biopsy examines circulating cellular components such as exosomes, nucleic acids, and cell-free DNA found in body fluids (e.g., urine, saliva, ascites, and pleural effusions) and provides information about tumor characteristics. Technical advances in liquid biopsy have led to the increasing adoption of diagnostic and monitoring applications for HCC. This review summarizes the various analytes, ongoing clinical trials, and case studies of United States Food and Drug Administrationapproved in vitro diagnostic applications for liquid biopsy, and provides insight into its implementation in managing HCC.
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Citations
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