Evidence map›Paper›PMID 37528255›Full record

ArticleJournal of gastroenterology2023

Efficacy and safety of atezolizumab plus bevacizumab treatment for unresectable hepatocellular carcinoma patients with esophageal-gastric varices.

Fujimasa Tada, Atsushi Hiraoka, Toshifumi Tada, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi and 34 more

Abstract read
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In one paragraph

Article in Journal of gastroenterology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.4field-weighted citation impact, top 18% 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

6 citing papers in PubMed, 7 citations in OpenAlex.

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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

44 authors at 20 institutions in 1 country.

Fujimasa TadaGastroenterology Center, Ehime Prefectural Central Hospital, 83 Kasuga-cho, Matsuyama, Ehime, 790-0024, Japan.
Atsushi HiraokaGastroenterology Center, Ehime Prefectural Central Hospital, 83 Kasuga-cho, Matsuyama, Ehime, 790-0024, Japan. hirage@m.ehime-u.ac.jp.ORCID 0000-0003-1989-0480
Toshifumi TadaDepartment of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan.
Masashi HirookaDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan.
Kazuya KariyamaDepartment of Hepatology, Okayama City Hospital, Okayama, Japan.
Joji TaniDepartment of Gastroenterology and Hepatology, Kagawa University, Takamatsu, 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 OchiCenter of Liver-Biliary-Pancreatic Disease, Matsuyama Red Cross Hospital, Matsuyama, Japan.
Hidenori ToyodaDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
Chikara OgawaDepartment of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Japan.
Takashi NishimuraDepartment of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan.
Takeshi HatanakaDepartment of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Gunma, 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 KawataHepatology Division, Department of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Atsushi NaganumaDepartment of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.
Hisashi KosakaDepartment of Surgery, Kansai Medical University, Hirakata, Japan.
Tomomitsu MatonoDepartment of Hepatology, Himeji St. Mary's Hospital, Himeji, Japan.
Hidekatsu KurodaDivision of Hepatology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan.
Yutaka YataDepartment of Gastroenterology, Hanwa Memorial Hospital, Osaka, Japan.
Hideko OhamaGastroenterology Center, Ehime Prefectural Central Hospital, 83 Kasuga-cho, Matsuyama, Ehime, 790-0024, Japan.
Kazuhiro NousoDepartment of Hepatology, Okayama City Hospital, Okayama, Japan.
Asahiro MorishitaDepartment of Gastroenterology and Hepatology, Kagawa University, Takamatsu, 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.
Keisuke YokohamaDepartment of Gastroenterology, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Hiroki NishikawaDepartment of Gastroenterology, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Michitaka ImaiDepartment of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.
Yohei KoizumiDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan.
Shinichiro NakamuraDepartment of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan.
Hiroko IijimaDepartment of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan.
Masaki KaiboriDepartment of Surgery, Kansai Medical University, Hirakata, Japan.
Yoichi HiasaDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan.
Takashi KumadaDepartment of Nursing, Gifu Kyoritsu University, Ogaki, Japan.
Real-life Practice Experts for HCC (RELPEC) Study Group, HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
Nippon Medical School · JPEhime Prefectural Central Hospital · JPEhime University · JPKagawa Prefectural Central Hospital · JPOsaka University of Pharmaceutical Sciences · JPHimeji Red Cross Hospital · JPHyogo Medical University · JPKagawa University · JPKansai Medical University · JPNational Hospital Organization Takasaki Medical Center · JPOkayama Prefecture · JPSaiseikai Niigata Daini Hospital · JPAsahi General Hospital · JPGifu Kyoritsu University · JPGunma Saiseikai Maebashi Hospital · JPHamamatsu University School of Medicine · JPHanwa Memorial Hospital · JPIwate Medical University · JPMatsuyama Red Cross Hospital · JPOgaki Municipal Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBevacizumab inhibits vascular endothelial growth factor-A (VEGF-A), though is known to increase bleeding risk as an adverse event (AE). This study examined whether atezolizumab/bevacizumab (Atez/Bev) for unresectable hepatocellular carcinoma (uHCC) can be used for patients with esophageal-gastric varices (EGV).

methodsFrom October 2020 to December 2022, 506 uHCC patients (median 74 years) underwent an upper gastrointestinal endoscopy examination were enrolled, after exclusion of those with portal vein tumor thrombus (PVTT). Patients with EGV (≧ F1) were defined as EGV positive, and the cohort was divided into non-EGV (n = 355) and EGV (n = 151). Before introducing Atez/Bev, endoscopic treatment was performed, when necessary. Prognosis was evaluated, retrospectively.

resultsThe EGV group had significantly worse hepatic function, lower platelet count, elevated alpha-fetoprotein, and lower rate of extrahepatic metastasis, and lower rate of first-line use (each P < 0.05) than the other. However, progression-free survival (PFS) was also not a significantly difference between the EGV and non-EGV groups in analyses with (PFS rate at 6/12/18 months: 60%/38%/30% vs. 65%/46%/34%, P = 0.29) or without inverse probability weighting adjustment [median: 10.6 months (95% CI 8.3-14.0) vs. 10.5 months (95% CI 7.8-13.7), P = 0.79]. As for AEs, diarrhea was more frequent in the EGV group (≧ G3: 2.0% vs. 0.3%, P = 0.036), while no significant difference was noted for EGV hemorrhage (≧ G3: 1.3% vs. 0.6%, P = 0.345). Of 28 patients who underwent endoscopic treatments before introducing Atez/Bev, none showed EGV-associated hemorrhage.

conclusionsAtez/Bev might be an effective therapeutic option in patients with EGV, when appropriate endoscopic treatment for EGV is performed.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsBevacizumabCarcinoma, HepatocellularEsophageal and Gastric VaricesLiver NeoplasmsAgedAged, 80 and overFemaleHumansMaleMiddle AgedPrognosisProgression-Free SurvivalRetrospective StudiesTreatment OutcomeAntibodies, Monoclonal, HumanizedatezolizumabBevacizumabVascular Endothelial Growth Factor AAtezolizumab plus bevacizumabHepatocellular carcinomaPortal hypertension

Identifiers

PMID37528255
OpenAlexW4385444242

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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.