ArticleJournal of gastroenterology2025
Proposal of discontinuation criteria of atezolizumab plus bevacizumab after curative conversion therapy for unresectable early-to-intermediate-stage hepatocellular carcinoma: a multicenter proof-of-concept study.
Article in Journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Durable complete response following sequential atezolizumab-bevacizumab and delayed transcatheter arterial embolization in advanced hepatocellular carcinoma.Clinical journal of gastroenterology · 2026Article
- Article
- Contrast-enhanced ultrasound findings are associated with tumor viability and depth of response in selected patients with unresectable hepatocellular carcinoma treated with immunotherapy-based combination therapy.Journal of medical ultrasonics (2001) · 2026Article
- Article
- Durable disease control in unresectable hepatocellular carcinoma with atezolizumab plus half-dose bevacizumab: pathological complete response of peritoneal metastasis.Clinical journal of gastroenterology · 2026Article
- Hepatocellular Carcinoma in the Eastern World: Screening, Diagnosis, Staging and Treatment.Current pharmaceutical design · 2026Review
- Multi-Target Tyrosine Kinase Inhibitors as Adjuvant Therapy for Hepatocellular Carcinoma Patients Who Achieve Complete Response After Transarterial Chemoembolization: A Real-World Study.Journal of hepatocellular carcinoma · 2026Article
- Multidisciplinary strategies including local treatment to achieve drug-free status after atezolizumab plus bevacizumab treatment in hepatocellular carcinoma.Oncology letters · 2025Article
- Article
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29 authors.
Funding
Abstract
backgroundAchieving complete response (CR) is a desirable goal in early-to-intermediate-stage hepatocellular carcinoma (HCC). While systemic and locoregional therapies show promise, optimal drug discontinuation criteria remain unclear. This study aims to investigate drug-off criteria for atezolizumab plus bevacizumab as a proof-of-concept study.
methodsThis retrospective multicenter study included child-pugh class A patients with unresectable HCC without extrahepatic spread or macrovascular invasion who received atezolizumab plus bevacizumab as first-line therapy. Modified clinical CR (mCCR) was defined as CR per mRECIST with sustained normal alpha-fetoprotein (AFP) levels (< 10.0 ng/dl). Recurrence-free survival (RFS) and overall survival (OS) were analyzed based on the "drug-off" criteria defined by following: (1) mRECIST CR with locoregional therapies, (2) sustained normalization of AFP/AFP-L3/ des-gamma-carboxy prothrombin (DCP) for 12-24 weeks, and (3) complete tumor vascularity disappearance by contrast-enhanced ultrasonography (CEUS) or pathological curative resection.
resultsThe median follow-up was 16.5 months (95% CI 15.2-17.8). Among 51 patients achieving mCCR, 11 underwent surgery, with pathological CR in three cases. In contrast, viable lesions were observed in 7 of 40 cases assessed using CEUS. All patients meeting the drug-off criteria (n = 9) showed no recurrence and none of them experienced mortality, while 45.2% (19/42) of those not meeting the criteria experienced recurrence (median RFS: 12.8 months, p = 0.007). The median OS was not reached in dug-off criteria met patients (n = 9), 37.7 months (95% CI: NA) in non-criteria met patients (n = 42), and 27.1 months (95% CI 16.7-37.6) in non-mCCR patients (n = 184) (p < 0.001).
conclusionIn patients with unresectable and TACE-unsuitable early-to-intermediate-stage HCC who met the drug-off criteria, significantly improved RFS and OS were observed compared those who did not meet the criteria. However, further validation studies are required to confirm the utility of the criteria.
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