Publications by authors named "Kaoru Tsuchiya"
Article Synopsis
- - This study explores the effectiveness of combining immune checkpoint inhibitors durvalumab and tremelimumab (DT) for patients with hepatocellular carcinoma (HCC) who previously received treatments like atezolizumab plus bevacizumab (AB).
- - Results showed objective response rates (ORRs) were highest in first-line treatment (44%), followed by second-line without prior AB (54%), and significantly lower in patients who had prior AB (5%), indicating that prior treatment heavily affects success.
- - The findings suggest that while DT may be less effective after AB treatment, it can still yield similar results to first-line therapy in patients without prior AB, highlighting the importance of treatment history when planning HCC therapy.
Background/aim: Maintaining liver function throughout the treatment of hepatocellular carcinoma (HCC) is crucial, yet the impact of durvalumab plus tremelimumab (DT) treatment on liver function is not well understood. This multicenter study aimed to examine the changes in liver function during DT treatment.
Patients And Methods: This nationwide multicenter study included 80 patients who received DT treatment for unresectable HCC.
Introduction: The phase III IMbrave150 study established atezolizumab + bevacizumab as the global standard of care in patients with unresectable hepatocellular carcinoma (HCC). This exploratory analysis examined the impact of bevacizumab interruption due to bevacizumab adverse events of special interest (AESIs).
Methods: Patients in IMbrave150 who were randomized to atezolizumab + bevacizumab and received treatment for ≥6 months (to reduce immortal time bias) were included in group A-1 if bevacizumab had ever been skipped due to bevacizumab AESIs or to group A-2 otherwise.
The enhanced liver fibrosis (ELF) score is a blood test that combines three markers linked to liver fibrosis. The utility of the ELF score has been demonstrated primarily in Western countries, but whether it is useful in areas with a high number of elderly people suffering from chronic liver disease has yet to be determined. This is a prospective study that included 373 consecutive patients who underwent a liver biopsy and had their ELF score measured on the same day.
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- This study assessed the safety and effectiveness of ramucirumab as a second- and third-line treatment for advanced hepatocellular carcinoma (HCC) in a real-world setting, complementing findings from the REACH-2 trial.
- Conducted in Japan with 19 enrolled patients, the study found a 6-month progression-free survival rate of 14.3%, with median progression-free survival and overall survival of 3.7 and 12.0 months, respectively.
- The most common severe adverse events included hypertension (23.5%), proteinuria (17.6%), and neutropenia (11.8%), with 29.4% of patients discontinuing treatment due to these adverse effects.
Introduction: Hepatic arterial infusion chemotherapy (HAIC) with cisplatin and lenvatinib exhibits strong antitumor effects against advanced hepatocellular carcinoma (HCC). Higher antitumor activity is expected for the combination treatment. The aim of this trial was to evaluate the efficacy and safety of lenvatinib in combination with HAIC using cisplatin in patients with advanced HCC.
View Article and Find Full Text PDFBackground And Aim: Magnetic resonance elastography (MRE) is used for the evaluation of liver fibrosis; however, it remains unclear whether MRE-based liver stiffness is associated with hepatocellular carcinoma (HCC) development, particularly in patients with chronic hepatitis B.
Methods: A total of 504 patients with chronic hepatitis B receiving MRE were enrolled. The was the association between MRE-based liver stiffness and HCC.
Background And Aim: Immune checkpoint inhibitors pose the risk of immune-related adverse events (irAEs). Recent data suggest that irAEs may be associated with a favorable prognosis. This study aimed to investigate and analyze the association between these adverse events and the clinical benefits in patients with unresectable hepatocellular carcinoma.
View Article and Find Full Text PDFAims: Optimizing glycemic control may prevent liver-related events and major adverse cardiovascular events (MACE) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). However, the optimal hemoglobin A1c (HbA1c) threshold associated with a lower risk of complications, particularly liver-related events as well as MACE is unknown.
Methods: We investigated a nationwide population-based cohort and identified 633 279 patients with MASLD, with a mean follow-up of 4.
Aim: A multisociety consensus group proposed a new nomenclature for metabolic dysfunction-associated steatotic liver disease (MASLD). Although patients with nonalcoholic fatty liver disease (NAFLD) are expected to be reclassified as patients with MASLD under the new nomenclature, the concordance between MASLD and NAFLD remains unclear. Moreover, waist circumference could be adjusted by ethnicity for diagnosing MASLD; however, there are limited data on the optimal waist circumference in the Japanese population.
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- Atezolizumab plus bevacizumab is an effective treatment for intermediate-stage hepatocellular carcinoma (HCC), achieving a 44% response rate, and potentially allows for curative conversion through additional therapies like resection or ablation.
- A study of 110 patients demonstrated that 35% achieved complete response (CR) after initial treatment, with various methods used for curative conversion, including resection and superselective TACE.
- Overall survival rates were positive, with no deaths among CR patients and stable liver function scores post-treatment, although some patients did experience recurrence.
Background: Advanced fibrosis detection in the general population is an unmet need. Additionally, screening method for advanced fibrosis in the general population is not established. Thus, this study aimed to examine the use of shear wave measurement (SWM), which measures liver stiffness by ultrasound elastography as a screening tool for advanced fibrosis in health checkups that represents the general population.
View Article and Find Full Text PDFObjective Pemafibrate is a recently developed selective peroxisome proliferator-activated receptor alpha modulator that can improve alanine aminotransferase (ALT) levels in patients with nonalcoholic fatty liver disease (NAFLD). However, the effectiveness of ALT normalization with pemafibrate and bezafibrate, a traditional fibrate, has not been compared. Methods In this retrospective study, we compared the effects of pemafibrate and bezafibrate on ALT normalization in patients with NAFLD.
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- The phase III IMbrave150 study confirmed that the combination of atezolizumab and bevacizumab is the standard treatment for patients with unresectable hepatocellular carcinoma (HCC), especially those with BCLC stage B disease.
- In this analysis, 74 patients with BCLC stage B were treated with either the combo therapy or sorafenib, showing a trend toward better overall survival and progression-free survival for those receiving atezolizumab+bevacizumab.
- The safety profile was consistent with previous findings, indicating that the combination therapy offers significant efficacy and manageable safety for this patient group.
Article Synopsis
- The study investigates whether switching from entecavir (ETV) to tenofovir alafenamide (TAF) helps maintain complete virological response (CVR) in chronic hepatitis B patients with low-level viremia (LLV) or occasional detectable HBV DNA.
- A total of 45 patients were followed for 2 years, showing an increase in CVR rates: from 33.3% with ETV to 68.9% after switching to TAF, indicating TAF is more effective.
- The findings suggest that transitioning to TAF could be a beneficial treatment option for patients not achieving stable HBV DNA levels on ETV.
The liquid CGP was useful for detecting FGFR2 fusion and the patient experienced typical side effects (nail disorders, hyperphosphatemia, and taste disorders) of pemigatinib that required treatment.
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- Patients with nonalcoholic fatty liver disease (NAFLD), whether lean or non-lean, are at risk for cardiovascular disease (CVD), but the risk for lean NAFLD is less understood.
- In a study of 581 Japanese NAFLD patients over 3 years, the incidence of new CVD was found to be 2.3% in lean NAFLD and 3.9% in non-lean NAFLD, with no significant difference.
- The findings suggest that age is a key risk factor for CVD, while having lean NAFLD does not increase the risk, indicating that CVD prevention should still be a focus for individuals with lean NAFLD.
This study aimed to describe the real-world efficacy and safety of the combination therapy of atezolizumab and bevacizumab (Atezo/Bev) for unresectable hepatocellular carcinoma (HCC). This retrospective analysis of a multicenter registry cohort included 268 patients treated with Atezo/Bev. The incidence of adverse events (AE) and its impact on overall survival (OS) and progression-free survival (PFS) were analyzed.
View Article and Find Full Text PDFThe fifth version of the Clinical Practice Guidelines for Hepatocellular Carcinoma was revised by the Japan Society of Hepatology, according to the methodology of evidence-based medicine and partly to the Grading of Recommendations Assessment, Development and Evaluation system, which was published in October 2021 in Japanese. In addition to surveillance-diagnostic and treatment algorithms, a new algorithm for systemic therapy has been created, as multiple drugs for hepatocellular carcinoma can be currently selected. Here, new or revised algorithms and evidence on which the recommendations are based are described.
View Article and Find Full Text PDFThe molecular mechanism of hepatocellular carcinoma (HCC) is partially demonstrated. Moreover, in the patients receiving multiple molecular-targeted therapies, the gene alternations are still unknown. Six molecular-targeted therapies of unresectable HCC (uHCC) and comprehensive genomic profiling (CGP) have been approved in clinical practice.
View Article and Find Full Text PDFThe number of patients with fatty liver has been increasing worldwide; however, the significance of fatty liver in patients with chronic hepatitis B who are receiving nucleic acid analog (NA) therapy remains unclear. Thus, we aimed to determine whether fatty liver affects the development of hepatocellular carcinoma (HCC) in patients receiving NA therapy. This study included 445 patients who received NA therapy, and the development of HCC was investigated.
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- Cabozantinib demonstrated a favorable risk-benefit ratio for Japanese patients with advanced liver cancer (HCC) based on a phase II study that analyzed data before the final database lock.* -
- Patients who had previously been treated with sorafenib experienced a median progression-free survival (PFS) of 7.4 months, while those who were naïve to sorafenib had a lower PFS of 3.6 months, with high disease control rates in both groups.* -
- Overall, cabozantinib showed efficacy with a manageable safety profile, with the most common side effects being skin reactions, diarrhea, and appetite loss, while liver function remained stable for ongoing patients.*
Introduction: The efficacy of systemic first-line treatments in older adults with unresectable hepatocellular carcinoma (HCC) has not been well-studied. We compared the safety and efficacy of atezolizumab plus bevacizumab versus sorafenib as a first-line treatment in younger versus older patients with unresectable HCC.
Methods: This global, phase 3, open-label, randomized clinical trial (IMbrave150) recruited patients aged ≥18 years with locally advanced metastatic or unresectable HCC, an Eastern Cooperative Oncology Group performance status score of 0 or 1, and Child-Pugh class A liver function who had not previously received systemic therapy for liver cancer.
Aims: Portopulmonary hypertension (PoPH) is a subtype of pulmonary arterial hypertension related to portal hypertension. The definitive diagnosis of PoPH is made by invasive right heart catheterization. Alternatively, pulmonary arterial hypertension may be recognized noninvasively from the tricuspid regurgitant pressure gradient (TRPG), measured by echocardiography.
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