Effect of Immunotherapy on Late Elderly Patients With Unresectable Hepatocellular Carcinoma: A Real‐World Clinical Study
ABSTRACT Background/Aim The global aging population includes an increasing number of elderly patients with hepatocellular carcinoma (HCC). This study aimed to clarify the real‐world outcomes, prognostic factors, and appropriate administration indicators for immunotherapy in elderly HCC patients. Met...
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2025-09-01
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| Online Access: | https://doi.org/10.1002/cam4.71171 |
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| author | Shun Kaneko Yasuhiro Asahina Miyako Murakawa Shunsuke Ueyama Hideki Watanabe Chiaki Maeyashiki Akiko Kusano‐Kitazume Ayako Sato Kozue Uchidate Taro Watabe Takehito Asakawa Sho Watanabe Junko Fujiki Isamu Shibata Shinya Oooka Hitoshi Kurata Mao Tsuchiya Takashi Fujii Keiichi Akahoshi Daisuke Ban Kento Inada Tsubasa Nobusawa Tomohiro Mochida Keiya Watakabe Taro Shimizu Jun Tsuchiya Masato Miyoshi Fukiko Kawai‐Kitahata Sayuri Nitta Mina Nakagawa Sei Kakinuma Ryuichi Okamoto Ochanomizu Liver Conference Study Group |
| author_facet | Shun Kaneko Yasuhiro Asahina Miyako Murakawa Shunsuke Ueyama Hideki Watanabe Chiaki Maeyashiki Akiko Kusano‐Kitazume Ayako Sato Kozue Uchidate Taro Watabe Takehito Asakawa Sho Watanabe Junko Fujiki Isamu Shibata Shinya Oooka Hitoshi Kurata Mao Tsuchiya Takashi Fujii Keiichi Akahoshi Daisuke Ban Kento Inada Tsubasa Nobusawa Tomohiro Mochida Keiya Watakabe Taro Shimizu Jun Tsuchiya Masato Miyoshi Fukiko Kawai‐Kitahata Sayuri Nitta Mina Nakagawa Sei Kakinuma Ryuichi Okamoto Ochanomizu Liver Conference Study Group |
| author_sort | Shun Kaneko |
| collection | DOAJ |
| description | ABSTRACT Background/Aim The global aging population includes an increasing number of elderly patients with hepatocellular carcinoma (HCC). This study aimed to clarify the real‐world outcomes, prognostic factors, and appropriate administration indicators for immunotherapy in elderly HCC patients. Methods This retrospective multicenter study analyzed 286 patients with unresectable HCC who received first‐line immunotherapy (atezolizumab–bevacizumab or durvalumab‐tremelimumab) between November 2020 and January 2024. Patients were categorized into the late elderly (LE; ≥ 75 years, n = 117) and non‐late elderly (non‐LE; ≤ 74 years, n = 169) groups. Baseline characteristics, overall survival (OS), progression‐free survival (PFS), and prognostic factors were evaluated. Results The LE group had significantly poorer performance status, lower albumin–bilirubin (ALBI) scores, lower alpha‐fetoprotein (AFP) and alanine transaminase levels, higher creatinine levels, and were significantly less likely to receive post‐immune checkpoint inhibitor (ICI) treatment compared with the non‐LE group (56.2% vs. 38.4%, p = 0.0038). Median OS and PFS for the LE group were 25.6 and 10.5 months, respectively. The LE group demonstrated a comparable disease control rate (82.0%) and safety profile. The ALBI score was a significant prognostic factor for both groups. Post‐ICI treatment significantly improved OS only in the non‐LE group, even after propensity score matching for ALBI score and AFP levels. Conclusions Immunotherapy is effective and well‐tolerated in LE patients with unresectable HCC, particularly in those with preserved liver function (mALBI grade 1/2a). Post‐ICI treatment significantly benefits non‐LE patients, with limited impact on LE patients, highlighting the need for therapeutic strategies based on age and liver function. |
| format | Article |
| id | doaj-art-f4a1c4e1c5884441a1d80b631fcd53e7 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Wiley |
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| series | Cancer Medicine |
| spelling | doaj-art-f4a1c4e1c5884441a1d80b631fcd53e72025-08-26T12:28:18ZengWileyCancer Medicine2045-76342025-09-011417n/an/a10.1002/cam4.71171Effect of Immunotherapy on Late Elderly Patients With Unresectable Hepatocellular Carcinoma: A Real‐World Clinical StudyShun Kaneko0Yasuhiro Asahina1Miyako Murakawa2Shunsuke Ueyama3Hideki Watanabe4Chiaki Maeyashiki5Akiko Kusano‐Kitazume6Ayako Sato7Kozue Uchidate8Taro Watabe9Takehito Asakawa10Sho Watanabe11Junko Fujiki12Isamu Shibata13Shinya Oooka14Hitoshi Kurata15Mao Tsuchiya16Takashi Fujii17Keiichi Akahoshi18Daisuke Ban19Kento Inada20Tsubasa Nobusawa21Tomohiro Mochida22Keiya Watakabe23Taro Shimizu24Jun Tsuchiya25Masato Miyoshi26Fukiko Kawai‐Kitahata27Sayuri Nitta28Mina Nakagawa29Sei Kakinuma30Ryuichi Okamoto31Ochanomizu Liver Conference Study GroupDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Tsuchiura Kyodo General Hospital Ibaraki JapanDepartment of Gastroenterology and Hepatology Yokosuka Kyosai Hospital Kanagawa JapanDepartment of Gastroenterology and Hepatology Musashino Red Cross Hospital Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Metropolitan Tama Medical Center Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Metropolitan Bokutoh Hospital Tokyo JapanDepartment of Gastroenterology and Hepatology JA Toride Medical Center Ibaraki JapanDepartment of Gastroenterology and Hepatology Ome Medical Center Tokyo JapanDepartment of Gastroenterology and Hepatology Yokohama City Minato Red Cross Hospital Kanagawa JapanDepartment of Gastroenterology and Hepatology Soka Municipal Hospital Saitama JapanDepartment of Gastroenterology and Hepatology Kashiwa Municipal Hospital Chiba JapanDepartment of Gastroenterology National Hospital Organization Disaster Medical Center Tokyo JapanDepartment of Medical Oncology Showa General Hospital Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Metropolitan Ohtsuka Hospital Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Kyosai Hospital Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Metropolitan Hiroo Hospital Tokyo JapanDepartment of Hepatobiliary and Pancreatic Surgery Institute of Science Tokyo Tokyo JapanDepartment of Hepatobiliary and Pancreatic Surgery Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanDepartment of Gastroenterology and Hepatology Institute of Science Tokyo Tokyo JapanABSTRACT Background/Aim The global aging population includes an increasing number of elderly patients with hepatocellular carcinoma (HCC). This study aimed to clarify the real‐world outcomes, prognostic factors, and appropriate administration indicators for immunotherapy in elderly HCC patients. Methods This retrospective multicenter study analyzed 286 patients with unresectable HCC who received first‐line immunotherapy (atezolizumab–bevacizumab or durvalumab‐tremelimumab) between November 2020 and January 2024. Patients were categorized into the late elderly (LE; ≥ 75 years, n = 117) and non‐late elderly (non‐LE; ≤ 74 years, n = 169) groups. Baseline characteristics, overall survival (OS), progression‐free survival (PFS), and prognostic factors were evaluated. Results The LE group had significantly poorer performance status, lower albumin–bilirubin (ALBI) scores, lower alpha‐fetoprotein (AFP) and alanine transaminase levels, higher creatinine levels, and were significantly less likely to receive post‐immune checkpoint inhibitor (ICI) treatment compared with the non‐LE group (56.2% vs. 38.4%, p = 0.0038). Median OS and PFS for the LE group were 25.6 and 10.5 months, respectively. The LE group demonstrated a comparable disease control rate (82.0%) and safety profile. The ALBI score was a significant prognostic factor for both groups. Post‐ICI treatment significantly improved OS only in the non‐LE group, even after propensity score matching for ALBI score and AFP levels. Conclusions Immunotherapy is effective and well‐tolerated in LE patients with unresectable HCC, particularly in those with preserved liver function (mALBI grade 1/2a). Post‐ICI treatment significantly benefits non‐LE patients, with limited impact on LE patients, highlighting the need for therapeutic strategies based on age and liver function.https://doi.org/10.1002/cam4.71171ALBI scoreatezolizumab plus bevacizumabdurvalumab‐tremelimumabhepatocellular carcinomapost‐ICI treatment |
| spellingShingle | Shun Kaneko Yasuhiro Asahina Miyako Murakawa Shunsuke Ueyama Hideki Watanabe Chiaki Maeyashiki Akiko Kusano‐Kitazume Ayako Sato Kozue Uchidate Taro Watabe Takehito Asakawa Sho Watanabe Junko Fujiki Isamu Shibata Shinya Oooka Hitoshi Kurata Mao Tsuchiya Takashi Fujii Keiichi Akahoshi Daisuke Ban Kento Inada Tsubasa Nobusawa Tomohiro Mochida Keiya Watakabe Taro Shimizu Jun Tsuchiya Masato Miyoshi Fukiko Kawai‐Kitahata Sayuri Nitta Mina Nakagawa Sei Kakinuma Ryuichi Okamoto Ochanomizu Liver Conference Study Group Effect of Immunotherapy on Late Elderly Patients With Unresectable Hepatocellular Carcinoma: A Real‐World Clinical Study Cancer Medicine ALBI score atezolizumab plus bevacizumab durvalumab‐tremelimumab hepatocellular carcinoma post‐ICI treatment |
| title | Effect of Immunotherapy on Late Elderly Patients With Unresectable Hepatocellular Carcinoma: A Real‐World Clinical Study |
| title_full | Effect of Immunotherapy on Late Elderly Patients With Unresectable Hepatocellular Carcinoma: A Real‐World Clinical Study |
| title_fullStr | Effect of Immunotherapy on Late Elderly Patients With Unresectable Hepatocellular Carcinoma: A Real‐World Clinical Study |
| title_full_unstemmed | Effect of Immunotherapy on Late Elderly Patients With Unresectable Hepatocellular Carcinoma: A Real‐World Clinical Study |
| title_short | Effect of Immunotherapy on Late Elderly Patients With Unresectable Hepatocellular Carcinoma: A Real‐World Clinical Study |
| title_sort | effect of immunotherapy on late elderly patients with unresectable hepatocellular carcinoma a real world clinical study |
| topic | ALBI score atezolizumab plus bevacizumab durvalumab‐tremelimumab hepatocellular carcinoma post‐ICI treatment |
| url | https://doi.org/10.1002/cam4.71171 |
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