TY - JOUR
T1 - Perfusion Change of Hepatocellular Carcinoma During Atezolizumab plus Bevacizumab Treatment
T2 - A Pilot Study
AU - Onuoha, Ezinwanne
AU - Smith, Andrew D.
AU - Cannon, Robert
AU - Khushman, Moh’d
AU - Kim, Harrison
N1 - Funding Information:
The authors thank Mr. Morgan Amos, Ms. Amanda Richardson, Ms. Haley Hendrix, and Ms. Brandi Barger for collecting clinical data. This study was supported by the department of radiology incentive grant at UAB and the UAB comprehensive cancer center (grant P30 CA13148).
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022
Y1 - 2022
N2 - Purpose: To investigate whether the early perfusion change in hepatocellular carcinoma (HCC) predicts the long-term therapeutic response to atezolizumab plus bevacizumab. Methods: We retrospectively selected 19 subjects (median age: 62 years, 4 females, and 15 males) having advanced HCC and treated with atezolizumab alone (n = 3) or in combination with bevacizumab (n = 16). The 4-phased CT or MRI imaging was performed for each subject before and at 9 ± 2 and 21 ± 5 weeks after therapy initiation. The tumor-to-liver signal ratio in the arterial phase was used to estimate the tumor perfusion. The change in tumor perfusion from the baseline to the 1st follow-up exam was correlated with the tumor response evaluated using mRECIST at the 2nd follow-up exam. The difference between favorably responding and non-responding groups was statistically analyzed using one-way ANOVA. Results: The mean tumor long axis in the baseline image was 59 ± 47 mm. The HCC perfusion changes were −26 ± 18% for complete (or partial) response (CR/PR, n = 8), −24 ± 12% for stable disease (SD, n = 8), and 9 ± 13% for progressive disease (PD, n = 3). The HCC perfusion change of the CR/PR groups was significantly lower than that of the PD group (p = 0.0040). The HCC perfusion changes between the SD and PD groups were also significantly different (p = 0.0135). The sensitivity and specificity of the early perfusion change to predict the long-term progression of the disease were 100 and 94%, respectively. Conclusion: The early change in HCC perfusion may predict the long-term therapeutic response to atezolizumab plus bevacizumab, promoting personalized treatment for HCC patients.
AB - Purpose: To investigate whether the early perfusion change in hepatocellular carcinoma (HCC) predicts the long-term therapeutic response to atezolizumab plus bevacizumab. Methods: We retrospectively selected 19 subjects (median age: 62 years, 4 females, and 15 males) having advanced HCC and treated with atezolizumab alone (n = 3) or in combination with bevacizumab (n = 16). The 4-phased CT or MRI imaging was performed for each subject before and at 9 ± 2 and 21 ± 5 weeks after therapy initiation. The tumor-to-liver signal ratio in the arterial phase was used to estimate the tumor perfusion. The change in tumor perfusion from the baseline to the 1st follow-up exam was correlated with the tumor response evaluated using mRECIST at the 2nd follow-up exam. The difference between favorably responding and non-responding groups was statistically analyzed using one-way ANOVA. Results: The mean tumor long axis in the baseline image was 59 ± 47 mm. The HCC perfusion changes were −26 ± 18% for complete (or partial) response (CR/PR, n = 8), −24 ± 12% for stable disease (SD, n = 8), and 9 ± 13% for progressive disease (PD, n = 3). The HCC perfusion change of the CR/PR groups was significantly lower than that of the PD group (p = 0.0040). The HCC perfusion changes between the SD and PD groups were also significantly different (p = 0.0135). The sensitivity and specificity of the early perfusion change to predict the long-term progression of the disease were 100 and 94%, respectively. Conclusion: The early change in HCC perfusion may predict the long-term therapeutic response to atezolizumab plus bevacizumab, promoting personalized treatment for HCC patients.
KW - Anti-angiogenic therapy
KW - Atezolizumab
KW - Bevacizumab
KW - Hepatocellular carcinoma
KW - Immune therapy
KW - Perfusion
KW - Therapy response assessment
UR - http://www.scopus.com/inward/record.url?scp=85137068032&partnerID=8YFLogxK
U2 - 10.1007/s12029-022-00858-4
DO - 10.1007/s12029-022-00858-4
M3 - Article
C2 - 36030519
AN - SCOPUS:85137068032
SN - 1941-6628
JO - Journal of Gastrointestinal Cancer
JF - Journal of Gastrointestinal Cancer
ER -