{
  "abstract": "Aims\n\nAtezolizumab combined with bevacizumab (AB therapy) is a standard first-line treatment for advanced hepatocellular carcinoma (HCC). However, clinically useful biomarkers for predicting therapeutic efficacy and severe adverse events (AEs) remain limited. Beyond its role in thrombosis, ADAMTS13-von Willebrand factor (VWF) axis is increasingly recognized for its involvement in angiogenesis and immune modulation. This study aimed to investigate the clinical significance of the ADAMTS13-VWF axis in patients receiving AB therapy.Methods\n\nA total of 58 patients with advanced HCC treated with AB therapy were enrolled. Plasma VWF antigen (VWF:Ag) and ADAMTS13 activity (ADAMTS13:AC) were measured before treatment initiation. Therapeutic efficacy was assessed using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and modified RECIST (mRECIST), while safety was assessed according to Common Terminology Criteria for AEs version 5.0.Results\n\nMultivariate analyses identified lower baseline VWF:Ag (< 180%) and ADAMTS13:AC (≤ 60%) as independent predictors of superior therapeutic efficacy according to both RECIST and mRECIST criteria. Patients with low VWF:Ag (< 180%) and ADAMTS13:AC (≤ 60%) exhibited significantly prolonged overall survival. Lower baseline VWF:Ag to ADAMTS13:AC (VWF/ADAMTS13) ratios (< 3) were independently associated with severe AEs (Grade ≥ 3). Plasma VWF:Ag and ADAMTS13:AC levels did not significantly change after AB therapy.Conclusion\n\nBaseline VWF:Ag and ADAMTS13:AC independently predict therapeutic efficacy, whereas the baseline VWF/ADAMTS13 ratio independently predicts severe AEs in patients with HCC receiving AB therapy. These biomarkers may help optimize patient selection and manage treatment-related toxicities by reflecting tumor angiogenic activity and host immune status.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gastroenterology Nara Medical University Nara Japan."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Naoki Nishimura"
    },
    {
      "affs": [
        0
      ],
      "name": "Hiroaki Takaya",
      "orcid": "0000-0002-4990-7573"
    },
    {
      "affs": [
        0
      ],
      "name": "Tadashi Namisaki",
      "orcid": "0000-0002-3158-5318"
    },
    {
      "affs": [
        0
      ],
      "name": "Yusuke Komeda"
    },
    {
      "affs": [
        0
      ],
      "name": "Satoshi Iwai",
      "orcid": "0000-0003-3575-5609"
    },
    {
      "affs": [
        0
      ],
      "name": "Akihiko Shibamoto",
      "orcid": "0009-0002-3665-0454"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuki Tsuji"
    },
    {
      "affs": [
        0
      ],
      "name": "Yukihisa Fujinaga",
      "orcid": "0000-0003-2402-574X"
    },
    {
      "affs": [
        0
      ],
      "name": "Koh Kitagawa",
      "orcid": "0000-0001-5794-1512"
    },
    {
      "affs": [
        0
      ],
      "name": "Shinya Sato",
      "orcid": "0000-0003-3049-3443"
    },
    {
      "affs": [
        0
      ],
      "name": "Norihisa Nishimura",
      "orcid": "0000-0002-6295-3283"
    },
    {
      "affs": [
        0
      ],
      "name": "Kosuke Kaji",
      "orcid": "0000-0002-1822-6759"
    },
    {
      "affs": [
        0
      ],
      "name": "Hitoshi Yoshiji",
      "orcid": "0000-0002-5243-8544"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fakwgyn5qdjtx.bib",
  "cited_by": 0,
  "doi": "10.1002/jgh3.70484",
  "fulltext_url": "https://europepmc.org/articles/PMC13711347",
  "id": "fakwgyn5qdjtx",
  "issns": [
    "2397-9070"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948561",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2721|Hepatocellular Carcinoma Treatment and Prognosis"
    ]
  ],
  "openalex": "W7223915929",
  "pdf_url": "https://europepmc.org/articles/PMC13711347?pdf=render",
  "pmcid": "PMC13711347",
  "pmid": "42948561",
  "published": "2026-10-27",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/fakwgyn5qdjtx.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:33Z",
      "native_id": "MED:42948561",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948561"
    },
    {
      "first_seen": "2026-10-31T12:22:08Z",
      "native_id": "PMC13711347",
      "source": "pmc",
      "url": "https://doi.org/10.1002/jgh3.70484"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2721|Hepatocellular Carcinoma Treatment and Prognosis",
      "subfield": "general"
    }
  ],
  "title": "von Willebrand Factor and ADAMTS13 Predict Therapeutic Efficacy and Severe Adverse Events in Advanced Hepatocellular Carcinoma Treated With Atezolizumab-Bevacizumab.",
  "title_text": "von Willebrand Factor and ADAMTS13 Predict Therapeutic Efficacy and Severe Adverse Events in Advanced Hepatocellular Carcinoma Treated With Atezolizumab-Bevacizumab.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:08Z",
  "url": "https://research.draconitic.com/paper/fakwgyn5qdjtx",
  "venue": "JGH open : an open access journal of gastroenterology and hepatology",
  "versions": []
}