Publications by authors named "Toshifumi Tada"
Article Synopsis
- * Real-time shear wave elastography (SWE) was used to measure liver stiffness and fibrosis stages in patients, with most showing low fibrosis levels and only one showing F3 fibrosis due to recurrent cholangitis.
- * The findings suggest that while liver fibrosis is rare in patients without complications post-surgery, those with long-term issues should be regularly checked using SWE to prevent overlooking potential liver cirrhosis.
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
- * 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
Aims: To evaluate the efficacy and safety of oral semaglutide for type 2 diabetes mellitus (T2DM) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).
Materials And Methods: This was a single-arm, multicentre, prospective study. Among 80 consecutive patients with MASLD and T2DM who newly received oral semaglutide, 70 completed 48-week oral semaglutide treatment as scheduled and were included in an efficacy analysis.
Article Synopsis
- * Patients taking metformin had significantly shorter OS (HR 1.9) and PFS (HR 1.6) compared to those not using the medication, while no such differences were found in the Lenvatinib cohort.
- * The findings suggest a negative impact of metformin usage on patient outcomes specifically in the context of Atezolizumab plus Bevacizumab treatment for HCC, highlighting the need for
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: 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
- The study aimed to find important biomarkers for predicting how patients with unresectable hepatocellular carcinoma (u-HCC) respond to a combination treatment of atezolizumab and bevacizumab (ATZ + BV).
- Researchers evaluated circulating tumor DNA (ctDNA) and levels of various immune-related cytokines in blood samples from 158 u-HCC patients to identify potential indicators of treatment outcomes.
- Key findings showed that while ctDNA mutations weren't correlated with treatment response, high levels of CXCL9 and low levels of LAG-3 were significant predictors of better progression-free survival and overall survival in patients undergoing ATZ + BV therapy.
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.
ALBI score predicts morphological changes in esophageal varices following direct-acting antiviral-induced sustained virological response in patients with liver cirrhosis.
J Gastroenterol
August 2024
Background: This study aimed to clarify the morphological changes in esophageal varices after achieving sustained virological response (SVR) with direct-acting antivirals (DAAs) in patients with cirrhosis.
Methods: A total of 243 patients underwent esophagogastroduodenoscopy before DAA treatment and after achieving SVR. Morphological changes in esophageal varices were investigated using esophagogastroduodenoscopy.
Background: At present, eradication regimens for non-Helicobacter pylori Helicobacter (NHPH) have not been established yet. We investigated effectiveness of the standard triple-drug combination therapy for Helicobacter pylori eradication and of a proton pump inhibitor (PPI) monotherapy in eradication of NHPH.
Methods: Subjects were the patients who were diagnosed with NHPH-infected gastritis based on microscopic findings, helical-shaped organisms obviously larger than Helicobacter pylori, in the gastric mucosal specimens using Giemsa staining at Kenwakai Hospital between November 2010 and September 2021, whose NHPH species were identified by polymerase chain reaction (PCR) analysis of urease genes in endoscopically-biopsied samples, and who consented to NHPH eradication with either the triple-drug combination therapy for one week or a PPI monotherapy for six months.
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.
Background: Non-Helicobacter pylori Helicobacter (NHPH) is rarely detected in duodenal mucosa due to its preference for slightly acidic environments. Here, we report four cases of NHPH-infected gastritis with duodenal spiral bacilli, potentially NHPH, indicating the possibility of duodenal mucosal infection.
Case Presentation: In every case, gastric mucosa showed endoscopic findings characteristic of NHPH-infected gastritis, and a mucosal biopsy was taken from the duodenal bulb; spiral bacilli were identified under microscopy using Giemsa staining.
Article Synopsis
- - This study conducts a meta-analysis to create a new grading system for liver steatosis using ultrasonography-based 2D-attenuation imaging (ATI), addressing the need for noninvasive tools in diagnosing liver disease.
- - Eleven studies with 1374 patients revealed that ATI correlates strongly with histological and MRI-PDFF-confirmed steatosis, allowing for classification into four grades (S0 to S3) based on specific ATI measurements.
- - The newly developed ATI grading system demonstrates high accuracy in determining liver steatosis, validated with independent patient cohorts and showing strong correlation with existing diagnostic methods.
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.