Conversion Ability of Immunotherapy in Hepatocellular Carcinoma: Insights from the International Converse Study

作者：Alessandro Vitale, Jung Sun Kim, Giuseppe Cabibbo, Andrea Casadei‐Gardini, Massimo Iavarone, Lorenza Rimassa, Francesca Romana Ponziani, Francesco Tovoli, Hong Jae Chon, Beodeul Kang, Chan Kim, Hiroshi Imaoka, Masafumi Ikeda, Masatoshi Kudo, Tomoko Aoki, Raffaella Tortora, Marco Guarracino, Bernardo Stefanini, Mariarosaria Marseglia, Alba Sparacino, Ciro Celsa, Mariangela Bruccoleri, Eleonora Alimenti, Fabio Marra, Claudia Campani, Sherrie Bhoori, Vincenzo Mazzaferro, Rodolfo Sacco, Antonio Facciorusso, Andréa Martini, Leonardo Stella, Lucia Cerrito, Hidenori Toyoda, Satoshi Yasuda, Federico Rossari, Margherita Rimini, Goki Suda, Takuya Sho, Gianluca Masi, Caterina Vivaldi, Tiziana Pressiani, Satoru Kakizaki, Atsushi Naganuma, Antonio Avallone, Anna Nappi, Gianpaolo Vidili, Caterina Soldà, Francesca Bergamo, David J. Pinato, Filippo Pelizzaro, Francesco Giuseppe Foschi, Alice Secomandi, Francesco Verderame, Enrico Bronte, Erika Martinelli, Donatella Marino, Sara Grasselli, Andrea Olivani, Maurizia Rossana Brunetto, Francesco Damone, Andrea Mega, Luca Marzi, Emiliano Tamburini, Matteo Ramundo, Piera Federico, Bruno Daniele, Edoardo G. Giannini, Andrea Pasta, Filomena Morisco, Maria Guarino, Celine Hoyek, Sara Boninsegna, Ajay Gupta, David Sacerdoti, Andrea Dalbeni, Inmaculada Ramos, Jorge Adeva, Carlo Saitta, Concetta Pitrone, Maria Luisa Lentini Graziano, Nunzia Farella, Maria Rendina, Teresa Grassi, Maria Grazia Rodriquenz, Evaristo Maiello, José Presa, Inês Pinho, Yoichi Hiasa, Masashi Hirooka, J.J. Chen, Gianluca Arrichiello, C. Aschele, Alessandro Furlanetto, Umberto Cillo · 发表于：Liver Cancer · 年份：2025 · DOI：10.1159/000547792 · 被引用次数：5 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cancer Immunotherapy and Biomarkers、Cholangiocarcinoma and Gallbladder Cancer Studies

<p>Introduction: The potential for curative conversion with immunotherapy-based systemic treatment used with noncurative intent in patients with hepatocellular carcinoma (HCC) remains debated. This study aimed to provide a reliable epidemiological snapshot of response patterns to atezolizumab plus bevacizumab (AB) therapy, with a focus on curative conversion rates. Methods: Patients with HCC undergoing first-line noncurative AB or lenvatinib (LENV, used as reference) from 2019 to 2023 were included, using centre-level aggregate data from a broad international consortium. The primary endpoint was the curative conversion rate, differentiating potential conversion (PC) – when objective response (OR) resulted in a consistent decrease in tumour burden and alpha-fetoprotein levels – from actual conversion (AC), when OR led to curative treatment. Secondary endpoints included OR, under-conversion (UC; [PC – AC]/OR) rates, and crude survival rates of AC patients. A meta-analytic approach was employed to analyse aggregate data. Results: Forty-eight international centres treating 2,379 patients with HCC with a noncurative intent (1,401 with AB and 978 with LENV) were included. A significant discrepancy was observed between PC (16% and 13% for AB and LENV, p = 0.03) and AC rates (3% for both AB and LENV, p = 0.14). UC rates remained similarly high (40% and 36% for AB and LENV, p = 0.93), despite differing OR rates (29% and 24% for AB and LENV, p = 0.01). Subgroup and meta-regressio...