Publications by authors named "Kazuya Kariyama"

Background And Aims: Methods for predicting therapeutic response to immune checkpoint inhibitors in cancer therapy are in high demand. In patients with advanced hepatocellular carcinoma (HCC), atezolizumab (anti-programmed cell death-ligand 1 [PD-L1]) and bevacizumab (anti-vascular endothelial growth factor) combination therapy (Atezo/Bev therapy) is a first-line treatment. However, no reliable biomarkers are currently available to predict its efficacy.

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Aim: Since the development of tremelimumab plus durvalumab (Dur/Tre) for unresectable hepatocellular carcinoma (uHCC), it has been used as not only an initial but also later line treatment in clinical practice. This study aimed to elucidate clinical prognostic factors for progression-free survival (PFS) in Dur/Tre treatment cases.

Methods: Enrolled were 183 uHCC patients treated with Dur/Tre from 2023 to May 2024 (median age, 74 years; male patients, 152; Child-Pugh class A:B, 150:33; Barcelona Clinic Liver Cancer stage B:C, 59:124; initial line use, 64).

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We previously found that "albumin grade", formerly called the "ALBS grade," demonstrated significant capability for prognostic stratification in hepatocellular carcinoma (HCC) patients treated with lenvatinib. The purpose of the present study was to compare the performance of the albumin grade with that of the modified albumin-bilirubin (mALBI) grade in predicting overall survival of HCC patients with different BCLC stages and treatment types. We enrolled 7,645 Japanese patients newly diagnosed with HCC using the Akaike information criteria (AIC), likelihood ratio, and C-index in different Barcelona Clinic Liver Cancer (BCLC) stages and treatments.

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Introduction: The most frequently used first-line treatment in patients with advanced hepatocellular carcinoma (HCC) is atezolizumab plus bevacizumab. Upon progression after this treatment, the standard of care in many countries is sorafenib, due to the lack of reimbursement for other drugs. Several randomized trials are currently underway to clarify the best second-line therapy in patients with HCC.

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Article Synopsis
  • * A retrospective analysis of 885 HCC patients showed no significant differences in overall survival, time to progression, or disease control rates between viral and nonviral patients treated with the combination therapy.
  • * Common prognostic factors were identified across both groups, but there might be some stronger associations between immunological factors and outcomes specifically in viral patients, while treatment-related toxicities and second-line treatments showed nearly identical results for both etiology subgroups.
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  • - This study investigates what factors predict conversion therapy success in patients with unresectable hepatocellular carcinoma (uHCC) and compares the survival outcomes of those who underwent conversion therapy to those with partial or complete responses after treatment with atezolizumab and bevacizumab.
  • - Out of 946 uHCC patients studied, only 43 (4.5%) received conversion therapy, with a higher overall response rate in this group (65.1%) compared to those who did not undergo conversion therapy (23.7%), indicating a statistically significant difference.
  • - Factors such as earlier BCLC stage, lack of macrovascular invasion or extrahepatic spread, and low neutrophil to lymphocyte ratio were found
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Introduction: Gastrointestinal varices rupture is considered to be prone to occur during atezolizumab and bevacizumab (Atez/Bev) treatment. This study aimed to investigate predictive factors affecting the increase in spleen volume (SpV) and the association of SpV variation with the clinical outcomes of Atez/Bev.

Methods: A total of 164 HCC patients were included in this retrospective multicenter study.

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Background And Aim: We conducted a study using the Fibrosis-3 (FIB-3) index, which is the established age-independent index of fibrosis in nonviral liver disease and addresses the limitations of the FIB-4 index in older age group, to assess the liver fibrosis risk among diverse demographic groups in the general population.

Methods: We analyzed 31 327 individuals who underwent health examinations between 2013 and 2020 and investigated the distribution of the FIB-3 index by age group. In addition, we examined the age distribution of the FIB-3 index stratified by background factors, such as sex, body mass index (BMI), alcohol consumption habits, and the presence or absence of fatty liver.

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Background: Addressing the limited access to treatments for alcohol dependence, we developed ALM-002, a therapeutic application to be "prescribed" for non-abstinence-oriented treatment in internal medicine settings. Our objective was to preliminarily assess the efficacy and safety of ALM-002.

Methods: In a multicenter, open-label randomized controlled trial, participants aged ≥20 with alcohol dependence and daily alcohol consumption exceeding 60 g for men and 40 g for women, without severe complications, were randomly assigned to either the intervention group using ALM-002 or the treatment-as-usual control group.

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Background: Atezolizumab plus bevacizumab (Atezo/Bev) is frequently selected as the primary systemic therapy for hepatocellular carcinoma (HCC).

Aims: To investigate the outcomes of patients with HCC treated with Atezo/Bev in a real-world setting based on whether they met the inclusion criteria for the phase 3 IMbrave150 trial.

Methods: A total of 936 patients were enrolled.

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Article Synopsis
  • * The research identified independent prognostic factors affecting overall survival and progression-free survival, notably the severity of decreased appetite, immunotoxicity, diarrhea, fatigue, arterial hypertension, and proteinuria.
  • * The findings underscore a significant relationship between the occurrence of AEs and therapy outcomes in HCC patients, similar to what has been observed in other treatment contexts, highlighting the importance of monitoring AEs for prognosis.
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Article Synopsis
  • Researchers found that the Fibrosis-3 (FIB-3) index can accurately predict liver fibrosis progression in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), regardless of age.
  • In a study of 1,398 patients, the FIB-3 index performed as well as the Fibrosis-4 (FIB-4) index for those under 60, but outperformed it for patients aged 60 and older.
  • The FIB-3 index’s effectiveness suggests it could be a more reliable tool for assessing liver fibrosis than existing methods, enhancing diagnosis across different age groups.
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Objective: We aimed to assess the prevalence of hazardous drinking and potential alcohol dependence among Japanese primary care patients, and their readiness to change and awareness of others' concerns.

Methods: From July to August 2023, we conducted a multi-site cross-sectional study as a screening survey for participants in a cluster randomized controlled trial. The trial included outpatients aged 20-74 from primary care clinics.

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  • Direct-acting antivirals (DAAs) were introduced in Japan in 2014, prompting a study to assess their impact on the prognosis of patients with hepatitis C virus (HCV)-associated hepatocellular carcinoma (HCC) by comparing outcomes before and after their availability.
  • The study analyzed 1949 patients, revealing that the post-DAA group had significantly better clinical outcomes, including higher rates of sustained virological response (SVR), improved liver function markers, and enhanced overall survival rates compared to the pre-DAA group.
  • The findings indicate that DAA therapy has significantly improved prognosis and treatment outcomes for patients with HCV-HCC, highlighting the importance of achieving SVR for better survival rates.
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Article Synopsis
  • The study aimed to develop a prognostic scoring system for patients with unresectable hepatocellular carcinoma (uHCC) treated with atezolizumab plus bevacizumab (Atez/Bev).
  • A total of 719 patients were analyzed, examining factors such as BCLC classification, AFP level, and mALBI scores to create the IMABALI-De scoring system, which showed better predictive ability for overall and progression-free survival compared to the CRAFITY score.
  • The IMABALI-De score demonstrated significant results, indicating it may be a more effective tool for predicting outcomes in patients undergoing this combination treatment for liver cancer.
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  • - The study examines the impact of Body Mass Index (BMI) on survival among patients with advanced liver cancer (HCC) undergoing first-line treatment with either atezolizumab plus bevacizumab or lenvatinib, focusing on underweight, normal-weight, and overweight classifications.
  • - In a cohort of 1,292 patients, results indicated that underweight individuals had significantly shorter overall survival (OS) compared to normal-weight patients, while no significant differences in OS were observed between normal and overweight patients.
  • - The research highlights the differing prognostic implications of BMI in cancer treatment, suggesting that underweight patients may require more focused clinical considerations in advanced HCC therapy.
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Background: To identify predictive factors associated with successful transition to conversion therapy following combination therapy with atezolizumab and bevacizumab in the treatment of unresectable hepatocellular carcinoma (HCC).

Methods: In total, 188 patients with HCC, who received atezolizumab plus bevacizumab combination therapy as the first-line chemotherapy, were studied. Patients who achieved complete response (CR) with systemic chemotherapy alone were excluded.

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Background And Aim: The study aims to develop a novel predictive model including the fibrosis (FIB)-3 index for hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C virus (HCV) who achieved sustained virological response (SVR) with direct-acting antiviral (DAA) therapy.

Methods: This study included 2529 patients in whom HCV was eradicated with DAA therapy. The after DAA recommendation for surveillance (ADRES) score, which is based on sex, FIB-4 index, and α-fetoprotein, was used to predict HCC development.

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Background: Data concerning the use of lenvatinib in very old patients (≥ 80 years) are limited, although the incidence of hepatocellular carcinoma (HCC) in this patient population is constantly increasing.

Objective: This analysis aimed to evaluate the efficacy and safety of lenvatinib in a large cohort of very old patients (≥ 80 years) with unresectable HCC.

Patients And Methods: The study was conducted on a cohort of 1325 patients from 46 centers in four Western and Eastern countries (Italy, Germany, Japan, and the Republic of Korea) who were undergoing first-line treatment with lenvatinib between July 2010 and February 2022.

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Introduction: Because of recent developments in treatments for hepatocellular carcinoma (HCC), methods for determining suitable therapy for initial or recurrent HCC have become important. This study used artificial intelligence (AI) findings to establish a system for predicting prognosis of HCC patients at time of reoccurrence based on clinical data as a reference for selection of treatment modalities.

Methods: As a training cohort, 5,701 observations obtained at the initial and each subsequent treatment for recurrence from 1,985 HCC patients at a single center from 2000 to 2021 were used.

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Atezolizumab plus bevacizumab (AB) and lenvatinib can be alternatively used as first-line systemic treatment of unresectable hepatocellular carcinoma (HCC). However, no direct comparison of the two regimens has been performed in randomized clinical trials, making the identification of baseline differential predictors of response of major relevance to tailor the best therapeutic option to each patient. Baseline clinical and laboratory characteristics of real-world AB-treated HCC patients were analyzed in uni- and multivariate analyses to find potential prognostic factors of overall survival (OS).

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Article Synopsis
  • The study aimed to compare the effects of two treatments, atezolizumab plus bevacizumab (Atez/Bev) and lenvatinib (LEN), on liver function in patients with hepatocellular carcinoma.
  • A total of 526 patients who received Atez/Bev and 731 who received LEN were analyzed, with 324 patients in each group after matching, using a model to evaluate liver health changes over time.
  • Both treatments led to similar deterioration in liver function scores, with significant worsening observed in LEN-treated patients who were at an advanced cancer stage or received a full dose, highlighting the need for caution in these cases.
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