Atezolizumab plus Bevacizumab Treatment Worsens Liver Reserve in Patients with Nafld/Nash-Associated Liver Cancer More than in Those with Non-nafld/Non-Nash-Associated Liver Cancer

Rie Sugimoto; Kenta Motomura; Takeaki Satoh; Yuki Tanaka; Shinsaku Yamashita; Nobito Higuchi; Toshimasa Koyanagi; Tsukasa Nakamura; Masatake Tanaka; Yuuki Azuma; Takeshi Goya; Akifumi Kuwano; Aritsune Ooho; Mari Ooe; Taiji Mutsuki; Masami Kuniyoshi; Kazuki Kurosaka; Yusuke Morita; Seiya Tada; Yoshifusa Aratake; Tsuyoshi Yoshimoto; Takeshi Senju; Tomoyuki Kurashige; Shigeru Harada; Akihiro Ueda; Masayuki Miyazaki; Makoto Nakamuta; Motoyuki Kohjima

doi:10.20944/preprints202310.1682.v1

Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Version 1 : Received: 26 October 2023 / Approved: 26 October 2023 / Online: 26 October 2023 (09:01:45 CEST)

(1) Background: Although multiple studies have reported on the therapeutic effects of Atezo+Bev for the treatment of NASH-related liver cancer, few studies have focused on its effect on liver reserve. Here, we aimed to compare the changes in hepatic reserve during the Atezo+Bev treatment of NAFLD/NASH-related HCC and of non-NAFLD/non-NASH-related HCC. (2) Methods: We retrospectively compared the changes in ALBI score in 109 patients with NAFLD/NASH or non-NAFLD/non-NASH during 12 weeks of treatment with Atezo+Bev for advanced HCC between September 2019 and January 2022. PSM was performed, and the OS, PFS, and PPS of the two groups were compared. (3)Results: The ALBI after 12 weeks of Atezo+Bev treatment was significantly worse in the NAFLD/NASH group than in the non-NAFLD/non-NASH group. Analysis of the 24 propensity score-matched pairs of cases with NAFLD/NASH or non-NAFLD non-NASH yielded similar results. The prognoses of the two groups were similar with respect to OS and PFS, but the NAFLD/NASH group had a significantly shorter PPS. The 24 matched pairs had similar OS and PFS, but the PPS of the NAFLD/NASH group was shorter. (4)Conclusion: Atezo+Bev treatment may worsen hepatic reserve, and there-fore life expectancy, in patients with NAFLD/NASH-related liver cancer.

Atezolizumab; bevacizumab; non-alcoholic fatty liver disease; non-alcoholic steato hepatitis; albumin-bilirubin (ALBI) score

Medicine and Pharmacology, Gastroenterology and Hepatology

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Atezolizumab plus Bevacizumab Treatment Worsens Liver Reserve in Patients with Nafld/Nash-Associated Liver Cancer More than in Those with Non-nafld/Non-Nash-Associated Liver Cancer

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