Publications by authors named "Takeshi Hatanaka"
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.
View Article and Find Full Text PDFEditorial: Predictive Factors and Survival Outcome of Conversion Therapy for Unresectable Hepatocellular Carcinoma Patients Receiving Atezolizumab and Bevacizumab: Comparative Analysis of Conversion, Partial Response and Complete Response Patients. Authors' Reply.
Aliment Pharmacol Ther
November 2024
Article Synopsis
- Durvalumab plus tremelimumab (Durva/Treme) is the first-line immunotherapy option for patients with unresectable hepatocellular carcinoma (HCC), with a reported objective response (OR) rate of 15.5%.
- The study involved 110 patients and aimed to identify whether changes in tumor markers, specifically alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP), could serve as predictive biomarkers for treatment response, using data collected both before and four weeks after treatment.
- It was found that higher baseline AFP levels (≥ 400 ng/mL) significantly correlated with better OR rates, and a ≥10% reduction in AFP or DCP
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.
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
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.
Article Synopsis
- Durvalumab plus tremelimumab (Dur/Tre) is approved for first-line treatment of unresectable hepatocellular carcinoma (u-HCC), but its real-world effectiveness is not well understood.
- A study involving 120 patients found an objective response rate (ORR) of 15.8%, a disease control rate (DCR) of 53.3%, and a median progression-free survival (PFS) of 3.9 months, alongside a high rate of adverse events (AEs).
- Although there was no significant difference in response and survival rates between those treated as first-line versus later-line, first-line therapy showed better disease control; careful management is needed for older patients or those with
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
- 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.
Atopic dermatitis is common in children and often treated with topical corticosteroids (TCs). A boy in his late teens who had been using TCs for atopic dermatitis was diagnosed with liver damage during a health checkup. A medical examination revealed severe steatotic liver disease and elevated liver enzyme levels despite the absence of typical symptoms such as central obesity.
View Article and Find Full Text PDFArticle 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.
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.
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).
View Article and Find Full Text PDFArticle 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.
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.
Background/aim: The aim of this study was to compare the therapeutic efficacy of ablation and surgery in solitary hepatocellular carcinoma (HCC) measuring ≤5 cm with a large HCC cohort database.
Methods: The study included consecutive 2,067 patients with solitary HCC who were treated with either ablation (n=1,248) or surgery (n=819). Th e patients were divided into three groups based on the tumor size and compared the outcomes of the two therapies using propensity score matching.
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.