Publications by authors named "Michitaka Imai"
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).
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.
View Article and Find Full Text PDFIntroduction: 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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- * 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.
Article Synopsis
- - 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
Article Synopsis
- The use of immune checkpoint inhibitors (ICIs) has led to increased incidents of ICI-induced liver injury, making it a significant concern for healthcare providers. !* -
- Severe liver injuries often require corticosteroid treatment, necessitating thorough evaluations including clinical assessments, blood tests, imaging, and sometimes liver biopsies for accurate diagnosis. !* -
- Distinguishing between types of liver injury, such as acute hepatitis-like effects and cholangitis, is crucial for effective treatment, with non-hepatocellular injuries often responding poorly to corticosteroids, highlighting the need for interdisciplinary cooperation in diagnosis and management. !*
Introduction: Lenvatinib is indicated for the forefront treatment of advanced hepatocellular carcinoma (aHCC), but its use may be limited by the risk of esophagogastric varices (EGV) bleeding. This study assessed the prevalence, predictors, and complications of EGV in aHCC patients treated with lenvatinib.
Methods: In this multicenter international retrospective study, cirrhotic patients treated with lenvatinib for aHCC, were enrolled if upper-gastrointestinal endoscopy was available within 6 months before treatment.
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.
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.
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.
Article Synopsis
- - 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.
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.
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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- 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.
Article Synopsis
- The study aimed to compare the effectiveness of two treatments, atezolizumab plus bevacizumab (Atez/Bev) and lenvatinib (LEN), for elderly patients (80 years and older) with advanced hepatocellular carcinoma (HCC).
- A total of 262 patients were analyzed, with similar age and gender distributions in both treatment groups, showing comparable objective response rates and overall survival.
- Atez/Bev demonstrated a higher incidence of postprogression treatment and a lower discontinuation rate due to side effects, suggesting it could be a viable first-line option for treating HCC in elderly patients.
Article Synopsis
- - The study aimed to compare the effectiveness of two treatments, atezolizumab plus bevacizumab (Atezo/Bev) and lenvatinib (LEN), in patients with intermediate-stage hepatocellular carcinoma (HCC) according to the Barcelona Clinic Liver Cancer (BCLC) staging system.
- - A total of 358 patients were evaluated, with those receiving Atezo/Bev experiencing a median progression-free survival (PFS) of 10.8 months, while those receiving LEN had a PFS of 7.3 months, indicating better outcomes for Atezo/Bev.
- - Overall, the findings suggest that Atezo/Bev as the first-line treatment leads to significantly longer progression
Aim: This study aimed to evaluate the ability of a previously reported tumor marker (TM) score involving alpha-fetoprotein (AFP), fucosylated AFP (AFP-L3), and des gamma-carboxy prothrombin (DCP) as TMs in predicting the prognosis and therapeutic efficacy in hepatocellular carcinoma (HCC) patients administered atezolizumab plus bevacizumab (Atez/Bev) as first-line treatment.
Materials/methods: The study period covered September 2020 to December 2022 and involved 371 HCC patients treated with Atez/Bev. The values of the TMs AFP, AFP-L3, and DCP were measured upon introducing Atez/Bev.
Background/aim: There is no known report regarding the relationship of atezolizumab plus bevacizumab (Atez/Bev) treatment with muscle volume loss (MVL) in unresectable hepatocellular carcinoma (u-HCC) patients. This study aimed to elucidate the clinical relationship between MVL and Atez/Bev.
Materials/methods: From September 2020 to December 2021, 229 u-HCC patients treated with Atez/Bev and with muscle volume data obtained by computed tomography at the baseline available were analyzed (median age, 74 years; males, 186 (81.
Article Synopsis
- Systemic treatment is suggested for Child-Pugh A patients with unresectable hepatocellular carcinoma (uHCC), and this study compares lenvatinib and the combination of atezolizumab and bevacizumab in CP-B patients.
- The study involved 128 patients, with a similar median age of 71, and looked at therapeutic responses, progression-free survival (PFS), and overall survival (OS) rates.
- Results showed no significant differences in best response rates, PFS, or OS between the two treatment groups, indicating both therapies may be equally effective for uHCC patients with CP-B status.
Background: Bevacizumab inhibits vascular endothelial growth factor-A (VEGF-A), though is known to increase bleeding risk as an adverse event (AE). This study examined whether atezolizumab/bevacizumab (Atez/Bev) for unresectable hepatocellular carcinoma (uHCC) can be used for patients with esophageal-gastric varices (EGV).
Methods: From October 2020 to December 2022, 506 uHCC patients (median 74 years) underwent an upper gastrointestinal endoscopy examination were enrolled, after exclusion of those with portal vein tumor thrombus (PVTT).
Article Synopsis
- The study aimed to assess the effectiveness of transarterial chemoembolization (TACE) using irinotecan-loaded drug-eluting beads in patients with colorectal cancer who have liver metastases and have not benefited from systemic chemotherapy.
- Forty-six patients were analyzed, divided into two groups: one receiving TACE with DEBIRI and the other not receiving it after undergoing multiple chemotherapy regimens.
- Results indicated that the TACE group had a median survival of 416 days compared to 229 days for the non-TACE group, suggesting TACE with DEBIRI significantly improves survival outcomes for these patients.*
Introduction: The aim of this retrospective proof-of-concept study was to compare different second-line treatments for patients with hepatocellular carcinoma and progressive disease (PD) after first-line lenvatinib or atezolizumab plus bevacizumab.
Materials And Methods: A total of 1381 patients had PD at first-line therapy. 917 patients received lenvatinib as first-line treatment, and 464 patients atezolizumab plus bevacizumab as first-line.
Article Synopsis
- * The study included 101 patients treated with lenvatinib and 29 controls, assessing outcomes like progression-free survival and overall survival, finding similar results between groups.
- * Lenvatinib showed reasonable effectiveness but didn't create a stronger "immunotherapy effect" post-Atez/Bev failure; it could be considered as effective as its initial use.
Aim: The present study focused on Geriatric Nutritional Risk Index (GNRI), which is based on bodyweight and serum albumin, and known as an easy-to-use nutritional assessment tool in clinical settings, to elucidate the prognostic predictive ability of GNRI in patients treated with atezolizumab plus bevacizumab (Atez/Bev) for hepatocellular carcinoma (HCC).
Methods: A total of 525 HCC patients treated with Atez/Bev, based on their classification of unsuitable status for curative treatments and/or transarterial catheter chemoembolization, were enrolled (Child-Pugh A:B:C = 484:40:1, Barcelona Clinic Liver Cancer stage 0:A:B:C:D = 7:25:192:283:18). Prognosis was evaluated retrospectively using GNRI.
Article Synopsis
- The study aimed to compare the effectiveness of atezolizumab plus bevacizumab (Atezo/Bev) as first-line versus later-line therapy for patients with unresectable hepatocellular carcinoma (HCC).
- Of the 430 patients analyzed, those receiving Atezo/Bev first-line had a median progression-free survival of 7.7 months, compared to 6.2 months for those on later-line therapy.
- Results suggest that starting treatment with Atezo/Bev can lead to better survival outcomes, particularly in patients with higher disease severity or prior exposure to other treatments.