Etiology of Hepatocellular Carcinoma May Influence the Pattern of Progression under Atezolizumab-Bevacizumab
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Preclinical models have shown that metabolic dysfunction-associated steatotic liver disease (MASLD)-related hepatocellular carcinoma (HCC) may exhibit reduced responsiveness to immunotherapy, especially for intrahepatic lesions due to liver tumor microenvironment. Radiological pattern of progression has been validated in clinical studies as a useful tool for predicting outcomes in HCC undergoing systemic treatments. Aims: The aim of this study was to determine whether MASLD influences the pattern of progression in patients treated with atezolizumab-bevacizumab. Methods: This multicenter, prospective study included patients with unresectable HCC receiving atezolizumab-bevacizumab. Progression patterns were defined as previously proposed. Patients were categorized as either MASLD or controls based on a recent multisocietal Delphi consensus statement. Multivariable models analyzed the risk of specific progression patterns and their impacts on post-progression survival (PPS) and overall survival (OS). A historical cohort treated with sorafenib was also analyzed to determine whether observed patterns were specific for atezolizumab-bevacizumab. Results: = 0.003]). Neither etiology nor IHG predicted a different PPS. No differences between etiologies were found in OS. Etiology did not influence the pattern of progression under sorafenib in the historical cohort. Conclusion: IHG was more frequently associated with MASLD-HCC compared to controls, confirming preclinical data and suggesting biological differences between tumors, with potential implications for future research. MASLD should not be seen as a contraindication to immunotherapy.
Source: Liver Cancer
DOI: 10.1159/000545494
Authors: Bernardo Stefanini, Fabio Piscaglia, Fabio Marra, Massimo Iavarone, Caterina Vivaldi, Giuseppe Cabibbo, Andrea Palloni, Tiziana Pressiani, Andrea Dalbeni, Benedetta Stefanini, Leonardo Stella, Piera Federico, Gianluca Svegliati-Baroni, Sara Lonardi, Caterina Soldà, Luca Ielasi, Stefania De Lorenzo, Ingrid Garajova, Claudia Campani, Mariangela Bruccoleri, Gianluca Masi, Ciro Celsa, Giovanni Brandi, Alessandra Auriemma, Bruno Daniele, Francesca Romana Ponziani, Lorenzo Lani, Rusi Chen, Maria Boe, Alessandro Granito, Lorenza Rimassa, Francesco Tovoli, on behalf of the ARTE study group
Institutions: IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola, University of Bologna, Azienda Ospedaliero-Universitaria Careggi, University of Florence, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Azienda Ospedaliera Universitaria Pisana, University of Palermo, IRCCS Humanitas Research Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Agostino Gemelli University Polyclinic, Regione Campania, Marche Polytechnic University, Istituto Oncologico Veneto, Ospedale per gli Infermi, Azienda USL di Bologna, Università Cattolica del Sacro Cuore, Humanitas University
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,590
OpenAlex ID: W4410740816