Evidence map›Paper›PMID 40922653›Full record

ArticleJournal of gastroenterology and hepatology2025

Hypertension as an Adverse Event Potentially Impacting the Therapeutic Efficacy of Atezolizumab Plus Bevacizumab in Patients With Unresectable Hepatocellular Carcinoma.

Kazuki Maesaka, Hayato Hikita, Machiko Kai, Yuki Tahata, Kumiko Shirai, Akira Doi, Kazuhiro Murai, Yoshinobu Saito, Ryoko Yamada, Takahiro Kodama and 20 more

Abstract readMulticenter Study
In one paragraph

Article in Journal of gastroenterology and hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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

30 authors.

Kazuki MaesakaDepartment of Gastroenterology and Hepatology, The University of Osaka Graduate School of Medicine, Osaka, Japan.ORCID https://orcid.org/0009-0007-5642-9470
Hayato HikitaDepartment of Gastroenterology and Hepatology, The University of Osaka Graduate School of Medicine, Osaka, Japan.ORCID https://orcid.org/0000-0003-2488-7315
Machiko KaiDepartment of Gastroenterology and Hepatology, The University of Osaka Graduate School of Medicine, Osaka, Japan.
Yuki TahataDepartment of Gastroenterology and Hepatology, The University of Osaka Graduate School of Medicine, Osaka, Japan.ORCID https://orcid.org/0000-0002-9116-7054
Kumiko ShiraiDepartment of Gastroenterology and Hepatology, The University of Osaka Graduate School of Medicine, Osaka, Japan.
Akira DoiDepartment of Gastroenterology and Hepatology, The University of Osaka Graduate School of Medicine, Osaka, Japan.
Kazuhiro MuraiDepartment of Gastroenterology and Hepatology, The University of Osaka Graduate School of Medicine, Osaka, Japan.
Yoshinobu SaitoDepartment of Gastroenterology and Hepatology, The University of Osaka Graduate School of Medicine, Osaka, Japan.
Ryoko YamadaDepartment of Gastroenterology and Hepatology, The University of Osaka Graduate School of Medicine, Osaka, Japan.
Takahiro KodamaDepartment of Gastroenterology and Hepatology, The University of Osaka Graduate School of Medicine, Osaka, Japan.ORCID https://orcid.org/0000-0002-6250-1324
Kazuyoshi OhkawaDepartment of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, Osaka, Osaka, Japan.
Masanori MiyazakiDepartment of Gastroenterology and Hepatology, Osaka International Medical & Science Center, Osaka Keisatsu Hospital, Osaka, Osaka, Japan.
Hisashi IshidaDepartment of Gastroenterology and Hepatology, Ikeda Municipal Hospital, Ikeda, Osaka, Japan.
Kengo MatsumotoDepartment of Gastroenterology and Hepatology, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan.
Yasutoshi NozakiDepartment of Gastroenterology and Hepatology, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.
Takayuki YakushijinDepartment of Gastroenterology and Hepatology, Osaka General Medical Center, Osaka, Osaka, Japan.
Ryotaro SakamoriDepartment of Gastroenterology and Hepatology, National Hospital Organization Osaka National Hospital, Osaka, Osaka, Japan.ORCID https://orcid.org/0000-0002-1580-607X
Nobuyuki TatsumiDepartment of Gastroenterology and Hepatology, Japan Community Healthcare Organization, Osaka Hospital, Osaka, Osaka, Japan.
Sadaharu IioDepartment of Gastroenterology and Hepatology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan.
Takatoshi NawaDepartment of Gastroenterology and Hepatology, Higashiosaka City Medical Center, Higashiosaka, Osaka, Japan.
Naruyasu KakitaDepartment of Gastroenterology and Hepatology, Kaizuka City Hospital, Kaizuka, Osaka, Japan.
Masanori NakaharaDepartment of Gastroenterology and Hepatology, Minoh City Hospital, Minoh, Osaka, Japan.
Atsushi HosuiDepartment of Gastroenterology and Hepatology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
Takeo UsuiDepartment of Gastroenterology and Hepatology, Ashiya Municipal Hospital, Ashiya, Hyogo, Japan.
Kazuho ImanakaDepartment of Gastroenterology and Hepatology, Itami City Hospital, Itami, Hyogo, Japan.
Yoshinori DoiDepartment of Gastroenterology and Hepatology, Otemae Hospital, Osaka, Osaka, Japan.
Mitsuru SakakibaraDepartment of Gastroenterology and Hepatology, Yao Municipal Hospital, Yao, Osaka, Japan.
Yuichi YoshidaDepartment of Gastroenterology and Hepatology, Suita Municipal Hospital, Suita, Osaka, Japan.
Tomohide TatsumiDepartment of Gastroenterology and Hepatology, The University of Osaka Graduate School of Medicine, Osaka, Japan.
Tetsuo TakeharaDepartment of Gastroenterology and Hepatology, The University of Osaka Graduate School of Medicine, Osaka, Japan.ORCID https://orcid.org/0000-0001-5036-3457

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimAtezolizumab plus bevacizumab is used as a first-line treatment for unresectable hepatocellular carcinoma (uHCC). However, the relationship between its adverse events (AEs) and treatment efficacy remains unclear. In this study, we aimed to clarify this association.

methodsThis study included 187 patients with uHCC treated with atezolizumab plus bevacizumab as first-line therapy at 19 affiliated hospitals in the Osaka Liver Forum. A landmark analysis was conducted to address biases in AE incidence.

resultsThe objective response and disease control rates were 28.2% and 69.6%, respectively. The median progression-free survival (PFS) and overall survival (OS) were 7.4 and 24.6 months, respectively. Among the 187 patients, 178 (95.2%) experienced at least one AE, with proteinuria being the most common (41.7%), followed by hypertension (34.8%) and fatigue (30.5%). All three major AEs had a median onset time of 6 weeks. We set the landmark point at Week 9 after treatment initiation, considering that the onset time for most AEs was within 9 weeks. In the landmark analysis, multivariable analysis identified the absence of bevacizumab interruption within 9 weeks and the occurrence of hypertension within 9 weeks as predictors of prolonged PFS. mALBI Grade 1/2a, the occurrence of hypertension, and the absence of fatigue and rash within 9 weeks were associated with prolonged OS. These results were consistent with those from the 6-week landmark analysis.

conclusionsPatients with hypertension occurring as an AE within 9 weeks are expected to have better PFS and OS with atezolizumab plus bevacizumab therapy for uHCC.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsBevacizumabCarcinoma, HepatocellularHypertensionLiver NeoplasmsAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedProgression-Free SurvivalRetrospective StudiesTreatment OutcomeAntibodies, Monoclonal, HumanizedatezolizumabBevacizumabadverse eventirAElandmark analysis

Identifiers

PMID40922653
PMCPMC12511841

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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.