Hepatitis C Eradication Improves Oncologic and Clinical Outcomes in Patients Treated With Atezolizumab Plus Bevacizumab

作者：Leonardo Stella, Giuseppe Cabibbo, Ciro Celsa, Roberta Ciccia, Alba Sparacino, Fabio Piscaglia, Francesco Tovoli, Andrea Arleo, Bernardo Stefanini, Massimo Iavarone, Roberta D’Ambrosio, Lucia Cerrito, Maria Pallozzi, Francesco Santopaolo, Fabio Marra, Claudia Campani, Chiara Mazzarelli, Raffaella Viganò, Raffaella Tortora, Alessio Aghemo, Stella De Nicola, Tiziana Pressiani, Lorenza Rimassa, Sherrie Bhoori, Salvatore Corallo, Laura Maiocchi, Andréa Martini, Caterina Soldà, Francesco Paolo Russo, Antonio Gasbarrini, Francesca Romana Ponziani · 发表于：Liver International · 年份：2025 · DOI：10.1111/liv.70362 · 被引用次数：7 · 研究领域：Hepatitis C virus research、Hepatocellular Carcinoma Treatment and Prognosis、Cancer Research and Treatment

BACKGROUND AND AIMS: Hepatitis C virus (HCV) is a key driver of hepatocellular carcinoma (HCC). However, the impact of HCV eradication on systemic therapy remains unclear. We aimed to assess the safety and efficacy of direct-acting antivirals (DAA) in patients treated with Atezolizumab plus Bevacizumab (AtezoBev). METHODS: This retrospective multicentre study included patients with HCV-related unresectable/advanced HCC treated with AtezoBev between 2021 and 2024. Three groups of patients were compared: Group A (n = 22), concurrent DAA with AtezoBev; Group B (n = 95), antiviral therapy before AtezoBev; and Group C (n = 22), active infection. RESULTS: Group A showed the longest median overall survival (42.8 months) compared to Group B (26.8 months; p = 0.03) and Group C (19.7 months; p = 0.01). Time to progression and progression-free survival were significantly prolonged in Group A versus Groups B and C. Moreover, Group A exhibited a higher disease control rate than the other groups. Post-DAA decompensation rates were significantly lower in Group A (4.5%) compared to Groups B (26.3%) and C (36.4%). Treatment-related adverse events of grade ≥ 3 were similar across groups. In the multivariate competing risk analysis with adjustment for time-dependent variables, achieving sustained virologic response during AtezoBev showed a protective effect against liver decompensation (sHR 0.02, p = 0.003) or tumour progression (sHR 0.14, p = 0.009), and was also associated with reduced mortal...