ArticleJournal of cancer research and clinical oncology2023
Clinical outcomes with atezolizumab plus bevacizumab or lenvatinib in patients with hepatocellular carcinoma: a multicenter real-world study.
Open access · greenAbstract readMulticenter Study
In one paragraph
Article in Journal of cancer research and clinical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 5 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 5 pooled it
3.9field-weighted citation impact, top 5% of its field
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.
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.
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Who cites it
20 citing papers in PubMed, 5 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Efficacy and Safety of Lenvatinib versus Atezolizumab Plus Bevacizumab in the Treatment of Unresectable Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.Asian Pacific journal of cancer prevention : APJCP · 2025Pooled it
- Efficacy of Atezolizumab Plus Bevacizumab Versus Lenvatinib in Patients with Unresectable Hepatocellular Carcinoma: a Meta-analysis.Journal of gastrointestinal cancer · 2024Pooled it
- Lenvatinib Versus Atezolizumab Plus Bevacizumab in the First-Line Treatment for Unresectable Hepatocellular Carcinoma: A Meta-Analysis of Real-World Studies.Targeted oncology · 2024Pooled it
- Efficacy and safety of atezolizumab plus bevacizumab versus lenvatinib for unresectable hepatocellular carcinoma: a systematic review and meta-analysis.Journal of cancer research and clinical oncology · 2023Pooled it
- The efficacy and safety of different systemic combination therapies on advanced hepatocellular carcinoma: a systematic review and meta-analysis.Frontiers in oncology · 2023Pooled it
- Article
- Efficacy and safety of tyrosine kinase inhibitors in advanced hepatocellular carcinoma patients with Child-Pugh A and B cirrhosis: a meta-analysis.Frontiers in pharmacology · 2026Review
- TKI plus ICI versus ICI alone in high tumor burden hepatocellular carcinoma: a retrospective cohort study.Journal of cancer research and clinical oncology · 2025Article
- Efficacy of atezolizumab plus bevacizumab for unresectable HCC: Systematic review and meta-analysis of real-world evidence.JHEP reports : innovation in hepatology · 2025Article
- Multi-Focused Acoustic Radiation Force Impulse Modulation of Murine Hepatic Xenografts Enhances Nanoscale DOX@Lip Delivery and Therapeutic Effect.International journal of nanomedicine · 2025Article
- Systemic Treatment for Unresectable Hepatocellular Carcinoma: A Surgeon's Perspective.Journal of hepatocellular carcinoma · 2025Review
- Adverse Events as Potential Predictive Factors of Activity in Patients with Advanced HCC Treated with Atezolizumab Plus Bevacizumab.Targeted oncology · 2024Article
- Exosomal PDL1 Suppresses the Anticancer Activity of CD8Analytical cellular pathology (Amsterdam) · 2024Article
- Differential liver function at cessation of atezolizumab-bevacizumab versus lenvatinib in HCC: a multicenter, propensity-score matched comparative study.Frontiers in oncology · 2024Article
- The New Era of Systemic Treatment for Hepatocellular Carcinoma: From the First Line to the Optimal Sequence.Current oncology (Toronto, Ont.) · 2023Review
- Article
- Atezolizumab plus bevacizumabClinical and experimental hepatology · 2023Article
- Article
- Higher Number of Tumor-Infiltrating PD-L1+ Cells Is Related to Better Response to Multikinase Inhibitors in Hepatocellular Carcinoma.Diagnostics (Basel, Switzerland) · 2023Article
- Management of Hepatocellular Carcinoma in Decompensated Cirrhotic Patients: A Comprehensive Overview.Cancers · 2023Review
Corrections and comments
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Authors and funding
80 authors at 20 institutions in 6 countries.
Mara Persano *Medical Oncology, University Hospital of Cagliari, Cagliari, Italy.
Margherita Rimini *Department of Medical Oncology, IRCCS San Raffaele Hospital, Via Olgettina n. 60, Milan, Italy. margherita.rimini@gmail.com.
Toshifumi TadaDepartment of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan.
Goki SudaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
Shigeo ShimoseDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan.
Masatoshi KudoDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan.
Jaekyung CheonDepartment of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
Fabian FinkelmeierDepartment of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
Ho Yeong LimDepartment of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea.
Lorenza RimassaDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
José PresaLiver Unit-CHTMAD, Vila Real, Portugal.
Gianluca MasiUnit of Medical Oncology 2, University Hospital of Pisa, Pisa, Italy.
Changhoon YooDepartment of Oncology, ASAN Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
Sara LonardiOncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
Francesco TovoliDivision of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy.
Takashi KumadaDepartment of Nursing, Gifu Kyoritsu University, Ogaki, Japan.
Naoya SakamotoDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
Hideki IwamotoDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan.
Tomoko AokiDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan.
Hong Jae ChonDepartment of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
Vera HimmelsbachDepartment of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
Tiziana PressianiHumanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Takumi KawaguchiDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan.
Margarida MontesLiver Unit-CHTMAD, Vila Real, Portugal.
Caterina VivaldiUnit of Medical Oncology 2, University Hospital of Pisa, Pisa, Italy.
Caterina SoldàOncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
Fabio PiscagliaDivision of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy.
Atsushi HiraokaGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.
Takuya ShoDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
Takashi NiizekiDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan.
Naoshi NishidaDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan.
Christoph SteupDepartment of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
Massimo IavaroneDivision of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.
Giovanni Di CostanzoDepartment of Hepatology, 80131, Naples, Italy.
Fabio MarraDipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Firenze, Italy.
Mario ScartozziMedical Oncology, University Hospital of Cagliari, Cagliari, Italy.
Emiliano TamburiniDepartment of Oncology and Palliative Care, Cardinale G Panico, Tricase City Hospital, Tricase, Italy.
Giuseppe CabibboSection of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127, Palermo, Italy.
Francesco Giuseppe FoschiDepartment of Internal Medicine, Ospedale per gli Infermi di Faenza, Faenza, Italy.
Marianna SillettaDivision of Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Masashi HirookaDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
Kazuya KariyamaDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan.
Joji TaniDepartment of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan.
Masanori AtsukawaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Koichi TakaguchiDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
Ei ItobayashiDepartment of Gastroenterology, Asahi General Hospital, Asahi, Japan.
Shinya FukunishiDepartment of Gastroenterology, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Kunihiko TsujiCenter of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
Toru IshikawaDepartment of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.
Kazuto TajiriDepartment of Gastroenterology, Toyama University Hospital, Toyama, Japan.
Hironori OchiHepato-biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Japan.
Satoshi YasudaDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
Hidenori ToyodaDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
Chikara OgawaDepartment of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Japan.
Takashi NishimuraDivision of Gastroenterology and Hepatology, Department of Internal medicine, Hyogo Medical University, Nishinomiya, Japan.
Takeshi HatanakaDepartment of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan.
Satoru KakizakiDepartment of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.
Noritomo ShimadaDivision of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Japan.
Kazuhito KawataDepartment of Hepatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Fujimasa TadaGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.
Hideko OhamaGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.
Kazuhiro NousoDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan.
Asahiro MorishitaDepartment of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan.
Akemi TsutsuiDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
Takuya NaganoDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
Norio ItokawaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Tomomi OkuboDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Taeang AraiDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Michitaka ImaiDepartment of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.
Hisashi KosakaDepartment of Surgery, Kansai Medical University, Osaka, Japan.
Atsushi NaganumaDepartment of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.
Yohei KoizumiDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan.
Shinichiro NakamuraDepartment of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan.
Masaki KaiboriDepartment of Surgery, Kansai Medical University, Osaka, Japan.
Hiroko IijimaDivision of Gastroenterology and Hepatology, Department of Internal medicine, Hyogo Medical University, Nishinomiya, Japan.
Yoichi HiasaDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
Antonella CammarotaDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Valentina BurgioDepartment of Medical Oncology, IRCCS San Raffaele Hospital, Via Olgettina n. 60, Milan, Italy.
Stefano CascinuDepartment of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Vita-Salute San Raffaele University, Milan, Italy.
Andrea Casadei-GardiniDepartment of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Vita-Salute San Raffaele University, Milan, Italy.
Kurume University · JPNippon Medical School · JPEhime Prefectural Central Hospital · JPHokkaido University · JPKagawa Prefectural Central Hospital · JPKindai University · JPOkayama Prefecture · JPAzienda Ospedaliera Universitaria Pisana · ITAzienda USL di Bologna · ITDireção Geral do Território · PTEhime University · JPGoethe University Frankfurt · DEHimeji Red Cross Hospital · JPHyogo University · JPIRCCS Humanitas Research Hospital · ITIstituti di Ricovero e Cura a Carattere Scientifico · ITIstituto di Ricovero e Cura a Carattere Scientifico San RaffaeleIstituto Oncologico Veneto · ITKagawa University · JPKansai Medical University · JP
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study is to compare response rates of lenvatinib and atezolizumab plus bevacizumab, in first-line real-world setting.
methodsOverall cohort included Western and Eastern hepatocellular carcinoma (HCC) patient populations from 46 centres in 4 countries (Italy, Germany, Japan, and Republic of Korea).
results1312 patients were treated with lenvatinib, and 823 patients were treated with atezolizumab plus bevacizumab. Objective response rate (ORR) was 38.6% for patients receiving lenvatinib, and 27.3% for patients receiving atezolizumab plus bevacizumab (p < 0.01; odds ratio 0.60). For patients who achieved complete response (CR), overall survival (OS) was not reached in both arms, but the result from univariate Cox regression model showed 62% reduction of death risk for patients treated with atezolizumab plus bevacizumab (p = 0.05). In all multivariate analyses, treatment arm was not found to be an independent factor conditioning OS. Comparing ORR achieved in the two arms, there was a statistically significant difference in favor of lenvatinib compared to atezolizumab plus bevacizumab in all subgroups except for Eastern patients, Child-Pugh B patients, presence of portal vein thrombosis, α-feto-protein ≥ 400 ng/mL, presence of extrahepatic disease, albumin-bilirubin (ALBI) grade 2, and no previous locoregional procedures.
conclusionLenvatinib achieves higher ORR in all patient subgroups. Patients who achieve CR with atezolizumab plus bevacizumab can achieve OS so far never recorded in HCC patients. This study did not highlight any factors that could identify patient subgroups capable of obtaining CR.
Indexed as
Carcinoma, HepatocellularLiver NeoplasmsAntibodies, Monoclonal, HumanizedBevacizumabHumansPhenylurea CompoundsQuinolinesAntibodies, Monoclonal, HumanizedatezolizumabBevacizumablenvatinibPhenylurea CompoundsQuinolinesAdvanced HCCAtezolizumab plus bevacizumabFirst-line therapyLenvatinib
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