Unresectable hepatocellular carcinoma at dawn of immunotherapy era: real-world data from the French prospective CHIEF cohort.

Abstract

BACKGROUND AND OBJECTIVES:

Hepatocellular carcinoma epidemiological data are limited in France. The Epidemio Liver Immunotherapy Tecentriq outcome research (ELITor) retrospective study, based on real-world data from the Carcinome HépatocellulaIrE en France (CHIEF) French cohort of hepatocellular carcinoma patients, aimed to get insight into the treatment patterns, the sociodemographic, clinical, biological, and etiological characteristics, and the quality of life of patients with unresectable hepatocellular carcinoma.

METHODS AND RESULTS:

Between 1 September 2019 and 4 December 2020, 367 patients from the CHIEF cohort received at least one locoregional (52.8%) chemoembolization or radioembolization or systemic treatment (88.3%) and were selected for ELITor. Most patients had a Barcelona Clinic Liver Cancer (BCLC) C (93.2%) hepatocellular carcinoma stage and were affected by cirrhosis (67.7%). Alcohol was confirmed as the main etiology both as a single etiology (29.1%) and in association with other risk factors (26.9%), mainly metabolic disorders (16.2%).Tyrosine-kinase inhibitors, mainly sorafenib, were the most administered systemic treatments in first line. Patients who received at least one combination of atezolizumab and bevacizumab during the study period ( N  = 53) had a better performance status and less portal hypertension frequency than the overall population and more hepatitis B virus infection and fewer metabolic disorders as single etiology. Overall, the global health score before treatment (62.3 ± 21.9) was in line with that of reference cancer patients and worsened in 51.9% of the cases after first-line palliative-intent treatment.

CONCLUSION:

This study provided real-life data on advanced hepatocellular carcinoma characteristics and treatment patterns and described the first patients to receive the atezolizumab-bevacizumab combination before it became the new standard of care for advanced hepatocellular carcinoma.

• Authors: Eric Nguyen-Khac, Pierre Nahon, Olivier Ganry, Hajer Ben Khadhra, Philippe Merle, Giuliana Amaddeo, Nathalie Ganne-Carrie, Christine Silvain, Jean-Marie Peron, Philippe Mathurin, Rodolphe Anty, Thomas Uguen, Thomas Decaens, Ghassan Riachi, Mohamed Bouattour, Aurore Baron, Jean-Pierre Bronowicki, Georges-Philippe Pageaux, Olivier Rosmorduc, Gérard Ducournau, Mélina Gilberg, Alexandre Tanang, Julien Dupin, Anika Gilbert-Marceau, Jean-Frédéric Blanc, French CHIEF cohort group
• Journal: European journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 35 Issue 10 Pg. 1168-1177 (10 01 2023) ISSN: 1473-5687 [Electronic] England
• PMID: 37577805 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Chemical References

• Bevacizumab

Topics

• Humans
• Carcinoma, Hepatocellular (therapy, drug therapy)
• Liver Neoplasms (therapy, drug therapy)
• Bevacizumab (adverse effects)
• Retrospective Studies
• Quality of Life
• Prospective Studies
• Chemoembolization, Therapeutic (adverse effects, methods)
• Immunotherapy (adverse effects)