Evidence map›Paper›PMID 36208496›Full record

ArticleESMO open2022

Atezolizumab plus bevacizumab versus lenvatinib or sorafenib in non-viral unresectable hepatocellular carcinoma: an international propensity score matching analysis.

M Rimini, L Rimassa, K Ueshima, V Burgio, S Shigeo, T Tada, G Suda, C Yoo, J Cheon, D J Pinato and 67 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESMO open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
87citing papers in PubMed, 9 pooled it
16.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

87 citing papers in PubMed, 9 syntheses or guidelines pooled it, 128 citations in OpenAlex.

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27 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

77 authors at 20 institutions in 4 countries.

M RiminiIRCCS San Raffaele Scientific Institute Hospital, Department of Oncology, Vita-Salute San Raffaele University, Milan, Italy.
L RimassaDepartment of Biomedical Sciences, Humanitas University, Milan, Italy; Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy.
K UeshimaDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan.
V BurgioIRCCS San Raffaele Scientific Institute Hospital, Department of Oncology, Vita-Salute San Raffaele University, Milan, Italy.
S ShigeoDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
T TadaDepartment of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan.
G SudaDepartment of Gastroenterology and Hepatology, Hokkaido, Japan; University Graduate School of Medicine, Sapporo, Japan.
C YooDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
J CheonDepartment of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
D J PinatoDepartment of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy.
S LonardiOncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
M ScartozziMedical Oncology, University and University Hospital of Cagliari, Cagliari, Italy.
M IavaroneDivision of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.
G G Di CostanzoDepartment of Hepatology, Naples, Italy.
F MarraDipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Firenze, Italy.
C SoldàOncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
E TamburiniDepartment of Oncology and Palliative Care, Cardinale Hospital, Naples, Italy.
F PiscagliaDivision of Internal Medicine, Hepatobiliary and Immunoallergic Disease, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
G MasiDepartment of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
G CabibboSection of Gastroenterology & Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy.
F G FoschiInternal Medicine, Infermi Hospital, Faenza (AUSL ROMAGNA), Ravenna, Italy.
M SillettaDivision of Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Italy.
T PressianiMedical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy.
N NishidaDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan.
H IwamotoDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
N SakamotoDepartment of Gastroenterology and Hepatology, Hokkaido, Japan; University Graduate School of Medicine, Sapporo, Japan.
B-Y RyooDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
H J ChonDepartment of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
F ClaudiaDepartment of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy.
T NiizekiDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
T ShoDepartment of Gastroenterology and Hepatology, Hokkaido, Japan; University Graduate School of Medicine, Sapporo, Japan.
B KangDepartment of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
A D'AlessioDepartment of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy.
T KumadaDepartment of Nursing, Gifu Kyoritsu University, Ogaki, Japan.
A HiraokaGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.
M HirookaDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
K KariyamaDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan.
J TaniDepartment of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan.
M AtsukawaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
K TakaguchiDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
E ItobayashiDepartment of Gastroenterology, Asahi General Hospital, Asahi, Japan.
S FukunishiPremier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Shinya Fukunishi, Osaka, Japan.
K TsujiCenter of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
T IshikawaDepartment of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.
K TajiriDepartment of Gastroenterology, Toyama University Hospital, Toyama, Japan.
H OchiHepato-biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Japan.
S YasudaDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
H ToyodaDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
C OgawaDepartment of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Japan.
T NishimurDepartment of Internal medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan.
T HatanakaDepartment of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan.
S KakizakiDepartment of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.
N ShimadaDivision of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Japan.
K KawataDepartment of Hepatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
T TanakaGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.
H OhamaPremier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Shinya Fukunishi, Osaka, Japan.
K NousoDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan.
A MorishitaDepartment of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan.
A TsutsuiDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
T NaganoDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
N ItokawaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
T OkuboDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
T AraiDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
M ImaiDepartment of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.
A NaganumaDepartment of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.
Y KoizumiDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
S NakamuraDepartment of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan.
K JokoHepato-biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Japan.
H IijimaDepartment of Internal medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan.
Y HiasaDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
F PedicaDepartment of Experimental Oncology, Pathology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
F De CobelliSchool of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
F RattiHepatobiliary Surgery Division, Liver Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy.
L AldrighettiHepatobiliary Surgery Division, Liver Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy.
M KudoDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan.
S CascinuDepartment of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy.
A Casadei-GardiniDepartment of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy. Electronic address: casadeigardini@gmail.com.
Istituti di Ricovero e Cura a Carattere Scientifico · ITNippon Medical School · JPVita-Salute San Raffaele University · ITEhime University · JPKagawa Prefectural Central Hospital · JPKindai University · JPKurume University · JPSapporo University · JPCHA University · KREhime Prefectural Central Hospital · JPHimeji Red Cross Hospital · JPHyogo Medical University · JPImperial College London · GBIRCCS Humanitas Research Hospital · ITKagawa University · JPMatsuyama Red Cross Hospital · JPNational Hospital Organization Takasaki Medical Center · JPOgaki Municipal Hospital · JPOkayama Prefecture · JPOsaka University of Pharmaceutical Sciences · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA growing body of evidence suggests that non-viral hepatocellular carcinoma (HCC) might benefit less from immunotherapy. MATERIALS AND

methodsWe carried out a retrospective analysis of prospectively collected data from consecutive patients with non-viral advanced HCC, treated with atezolizumab plus bevacizumab, lenvatinib, or sorafenib, in 36 centers in 4 countries (Italy, Japan, Republic of Korea, and UK). The primary endpoint was overall survival (OS) with atezolizumab plus bevacizumab versus lenvatinib. Secondary endpoints were progression-free survival (PFS) with atezolizumab plus bevacizumab versus lenvatinib, and OS and PFS with atezolizumab plus bevacizumab versus sorafenib. For the primary and secondary endpoints, we carried out the analysis on the whole population first, and then we divided the cohort into two groups: non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) population and non-NAFLD/NASH population.

resultsOne hundred and ninety patients received atezolizumab plus bevacizumab, 569 patients received lenvatinib, and 210 patients received sorafenib. In the whole population, multivariate analysis showed that treatment with lenvatinib was associated with a longer OS [hazard ratio (HR) 0.65; 95% confidence interval (CI) 0.44-0.95; P = 0.0268] and PFS (HR 0.67; 95% CI 0.51-0.86; P = 0.002) compared to atezolizumab plus bevacizumab. In the NAFLD/NASH population, multivariate analysis confirmed that lenvatinib treatment was associated with a longer OS (HR 0.46; 95% CI 0.26-0.84; P = 0.0110) and PFS (HR 0.55; 95% CI 0.38-0.82; P = 0.031) compared to atezolizumab plus bevacizumab. In the subgroup of non-NAFLD/NASH patients, no difference in OS or PFS was observed between patients treated with lenvatinib and those treated with atezolizumab plus bevacizumab. All these results were confirmed following propensity score matching analysis. By comparing patients receiving atezolizumab plus bevacizumab versus sorafenib, no statistically significant difference in survival was observed.

conclusionsThe present analysis conducted on a large number of advanced non-viral HCC patients showed for the first time that treatment with lenvatinib is associated with a significant survival benefit compared to atezolizumab plus bevacizumab, in particular in patients with NAFLD/NASH-related HCC.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsNon-alcoholic Fatty Liver DiseaseAntibodies, Monoclonal, HumanizedBevacizumabHumansPhenylurea CompoundsPropensity ScoreQuinolinesRetrospective StudiesSorafenibAntibodies, Monoclonal, HumanizedatezolizumabBevacizumablenvatinibPhenylurea CompoundsQuinolinesSorafenibadvanced HCCatezolizumabbevacizumablenvatinibNAFLDNASHsorafenib

Identifiers

PMID36208496
PMCPMC9808460
OpenAlexW4302029115

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.