Evidence map›Paper›PMID 36976353›Full record

ArticleJournal of cancer research and clinical oncology2023

Survival outcomes from atezolizumab plus bevacizumab versus Lenvatinib in Child Pugh B unresectable hepatocellular carcinoma patients.

Margherita Rimini, Mara Persano, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, José Presa and 58 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
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 25 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 5 pooled it
6.9field-weighted citation impact, top 2% 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

25 citing papers in PubMed, 5 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Pooled it
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  6. Trial
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  10. Article
  11. Efficacy and Safety of Atezolizumab Plus Bevacizumab for Patients With Hepatocellular Carcinoma and Child-Pugh Class B.Liver international : official journal of the International Association for the Study of the Liver · 2026
    Article
  12. Impact of Child Pugh B Stage for the Treatment of Advanced HCC.Journal of hepatocellular carcinoma · 2026
    Review
  13. Article
  14. Future perspectives on immunotherapy for hepatocellular carcinoma.Therapeutic advances in medical oncology · 2025
    Review
  15. Article
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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

68 authors at 20 institutions in 5 countries.

Margherita RiminiDepartment of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy. margherita.rimini@gmail.com.
Mara PersanoMedical Oncology, University and University Hospital of Cagliari, Cagliari, Italy.
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, Faculty of Medicine, Kindai University, Osaka-Sayama, 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, School of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea.
José PresaUnidade de Hepatologia, CHTMAD, Vila Real, Portugal.
Francesca SalaniUnit of Medical Oncology 2, University Hospital of Pisa, Pisa, Italy.
Sara LonardiOncology 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, Bologna, Italy.
Takashi KumadaDepartment of Nursing, Gifu Kyoritsu University, Ogaki, Japan.
Naoya SakamotoDepartment of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan.
Hideki IwamotoDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
Tomoko AokiDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan.
Hong Jae ChonDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan.
Vera HimmelsbachDepartment of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
Marta SchirripaMedical Oncology Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Strada Sammartinese Snc, 01100, Viterbo, Italy.
Margarida MontesDepartment of Medicine, School of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea.
Caterina VivaldiUnidade de Hepatologia, CHTMAD, Vila Real, Portugal.
Caterina SoldàOncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
Atsushi HiraokaDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
Takuya ShoDepartment of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan.
Takashi NiizekiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
Naoshi NishidaDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan.
Christoph SteupDepartment of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
Masashi HirookaDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan.
Kazuya KariyamaDepartment of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan.
Joji TaniDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Masanori AtsukawaDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
Koichi TakaguchiDepartment of Gastroenterology, Asahi General Hospital, Asahi, Japan.
Ei ItobayashiDepartment of Gastroenterology, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Shinya FukunishiCenter of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
Kunihiko TsujiDepartment of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.
Toru IshikawaDepartment of Gastroenterology, Toyama University Hospital, Toyama, Japan.
Kazuto TajiriHepato-Biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Japan.
Hironori OchiDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
Satoshi YasudaDepartment of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Japan.
Hidenori ToyodaDepartment of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Japan.
Chikara OgawaDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo Medical University, Nishinomiya, Japan.
Takashi NishimuraDepartment of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan.
Takeshi HatanakaDepartment of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.
Satoru KakizakiDivision of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Japan.
Noritomo ShimadaDepartment of Hepatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Kazuhito KawataDepartment of Surgery, Kansai Medical University, Osaka, Japan.
Fujimasa TadaDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
Hideko OhamaDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
Kazuhiro NousoDepartment of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan.
Asahiro MorishitaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Akemi TsutsuiDepartment of Gastroenterology, Asahi General Hospital, Asahi, Japan.
Takuya NaganoDepartment of Gastroenterology, Asahi General Hospital, Asahi, Japan.
Norio ItokawaDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
Tomomi OkuboDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
Taeang AraiDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
Michitaka ImaiDepartment of Gastroenterology, Toyama University Hospital, Toyama, Japan.
Hisashi KosakaDepartment of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.
Atsushi NaganumaDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.
Yohei KoizumiDepartment of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan.
Shinichiro NakamuraMedical Oncology, University and University Hospital of Cagliari, Cagliari, Italy.
Masaki KaiboriDepartment of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.
Hiroko IijimaDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo Medical University, Nishinomiya, Japan.
Yoichi HiasaDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan.
Valentina BurgioDepartment of Oncology, IRCCS San Raffaele Hospital, Milan, Italy.
Mario ScartozziMedical Oncology, University and University Hospital of Cagliari, Cagliari, Italy.
Stefano CascinuDepartment of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy.
Andrea Casadei-GardiniDepartment of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy.
Kagawa Prefectural Central Hospital · JPAsahi General Hospital · JPEhime University · JPHimeji Red Cross Hospital · JPHokkaido University · JPIstituti di Ricovero e Cura a Carattere Scientifico · ITKagawa University · JPKurume University · JPNational Hospital Organization Takasaki Medical Center · JPUniversity of Cagliari · ITAzienda Ospedaliera Universitaria Pisana · ITCHA University Bundang Medical Center · KRHyogo University · JPKindai University · JPNippon Medical School · JPOkayama Prefecture · JPSungkyunkwan University · KRTakamatsu Red Cross Hospital · JPToyama University Hospital · JPVita-Salute San Raffaele University · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe best first-line treatment for patients with advanced hepatocellular carcinoma (HCC) and Child-Pugh (CP) class B remains unknown. The aim of the present study was to perform a real-world analysis on a large sample of patients with unresectable HCC with CP B treated with atezolizumab plus bevacizumab Vs Lenvatinib.

methodsThe study population included patients affected by advanced (BCLC-C) or intermediate (BCLC-B) HCC patients not suitable for locoregional therapies from both the Western and Eastern world (Italy, Germany, Republic of Korea and Japan), who received atezolizumab plus bevacizumab or Lenvatinib as first-line treatment. All the study population presented a CP class of B. The primary endpoint of the study was the overall survival (OS) of CP B patients treated with Lenvatinib compared to atezolizumab plus bevacizumab. Survival curves were estimated using the product-limit method of Kaplan-Meier. The role of stratification factors was analyzed with log-rank tests. Finally, an interaction test was performed for the main baseline clinical characteristics.

results217 CP B HCC patients were enrolled in the study: 65 (30%) received atezolizumab plus bevacizumab, and 152 (70%) received lenvatinib. The mOS for patients receiving Lenvatinib was 13.8 months (95% CI: 11.6-16.0), compared to 8.2 months (95% CI 6.3-10.2) for patients receiving atezolizumab plus bevacizumab as first-line treatment (atezolizumab plus bevacizumab Vs Lenvatinib: HR 1.9, 95% CI 1.2-3.0, p = 0.0050). No statistically significant differences were highlighted in terms of mPFS. The multivariate analysis confirmed that patients receiving Lenvatinib as first-line treatment have a significantly longer OS compared to patients receiving atezolizumab plus bevacizumab (HR 2.01; 95% CI 1.29-3.25, p = 0.0023). By evaluating the cohort of patients who received atezolizumab plus bevacizumab, we found that Child B patients with ECOG PS 0, or BCLC B stage or ALBI grade 1 were those who had benefited from the treatment thus showing survival outcomes no significantly different compared to those receiving Lenvatinib.

conclusionThe present study suggests for the first time a major benefit from Lenvatinib compared to atezolizumab plus bevacizumab in a large cohort of patients with CP B class HCC.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsAntibodies, Monoclonal, HumanizedBevacizumabHumansPhenylurea CompoundsQuinolinesAntibodies, Monoclonal, HumanizedatezolizumabBevacizumablenvatinibPhenylurea CompoundsQuinolinesAdvanced HCCAtezolizumabBevacizumabReal Word

Identifiers

PMID36976353
PMCPMC11798051
OpenAlexW4361191291

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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.