ArticleLiver international : official journal of the International Association for the Study of the Liver2026
Stratifying Cardiovascular Risk in Patients With HCC Receiving Atezolizumab/Bevacizumab: A Comparison of ESC and CARDIOSOR Scores.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06806579 (Atezolizumab-bevacizumab and Other Immunotherapies), which is not on this map. Cited by 1 paper.
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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.
Atezolizumab-bevacizumab and Other Immunotherapies: Real-life Experience for Treatment of Hepatocellular Carcinoma
Who cites it
1 citing paper in PubMed.
- Stratifying Cardiovascular Risk in Patients With HCC Receiving Atezolizumab/Bevacizumab: A Comparison of ESC and CARDIOSOR Scores.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
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33 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsThe management of comorbidities has become increasingly relevant in unresectable hepatocellular carcinoma (uHCC) as immunotherapy prolongs survival. Atezolizumab plus bevacizumab (AB) is a standard first-line option, but bevacizumab carries a risk of cardiovascular toxicities. Data on cardiovascular risk stratification in patients with cirrhosis remain limited. Identifying patients at increased cardiovascular risk is therefore clinically important, particularly given the availability of bevacizumab-free alternatives.
methodsWe retrospectively analysed prospectively collected data from the multicenter Italian ARTE database, including patients with uHCC treated with first-line AB between June 2022 and July 2025. Traditional major adverse cardiovascular events (tMACE) were defined as acute coronary syndromes, heart failure, cerebrovascular events, or peripheral ischemia, while an extended composite (eMACE) additionally included venous thromboembolism and immune-related myocarditis. Cardiovascular risk was stratified using the European Society of Cardiology (ESC) Cardio-Oncology classification and the CARDIOSOR score. Competing-risk analyses were performed considering treatment discontinuation as a competing event.
resultsThis study included 538 patients (median age 69.8 years). During follow-up, 20 patients (3.7%) experienced tMACE, and 30 (5.6%) experienced eMACE. Patients assigned to the very high-risk category by ESC criteria and those with a high-risk CARDIOSOR score had a significantly increased risk of tMACE and eMACE. Both scores demonstrated a moderate ability to stratify cardiovascular risk (Harrell's c-index 0.68 for ESC and 0.59 for CARDIOSOR).
conclusionsCardiovascular adverse events were uncommon overall, but their incidence was not negligible in patients in high-risk subgroups. Risk scores may help identify vulnerable subgroups and support patient-tailored treatment strategies, including consideration of bevacizumab-free regimens in selected cases.
trial registrationMulticenter ARTE database (NCT06806579).
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