Atezolizumab Plus Bevacizumab Treatment for Patients With Hepatocellular Carcinoma in the Barcelona Clinic Liver Cancer B2 Stage
11 affiliations
- 1Division of Gastroenterology Tohoku University Hospital Sendai Japan
- 2Institute for Excellence in Higher Education Tohoku University Sendai Japan
- 3Gastroenterology Center Ehime Prefectural Central Hospital Matsuyama Ehime Japan
- 4Division of Gastroenterology and Hepatology, Department of Internal Medicine Iwate Medical University Shiwa Iwate Japan
- 5Department of Gastroenterology Fukushima Medical University School of Medicine Fukushima Japan
- 6Department of Gastroenterology Yamagata University Faculty of Medicine Yamagata Japan
- 7Department of Gastroenterology, Graduate School of Medicine Akita University Akita Japan
- 8Department of Gastroenterology Hirosaki University Graduate School of Medicine Hirosaki Japan
- 9Department of Gastroenterology National Hospital Organization Sendai Medical Center Sendai Japan
- 10Department of Gastroenterology Aomori Prefectural Central Hospital Aomori Japan
- 11Tohoku Central Hospital Yamagata Japan
Abstract
Background and Aim: The optimal treatment strategy for patients with intermediate‐stage hepatocellular carcinoma beyond the up‐to‐seven criteria (Barcelona Clinic Liver Cancer B2) remains uncertain. Although transarterial chemoembolization has long been the standard of care, its efficacy is limited in this subgroup, and systemic therapies have recently been introduced. We aimed to explore treatment modalities associated with survival beyond that predicted by a previously validated prognostic model.
Methods: We retrospectively analyzed 113 patients diagnosed with BCLC‐B2 stage hepatocellular carcinoma between 2017 and 2024. Predicted survival was calculated using a previously established prognostic model, and treatment benefits were evaluated by comparing observed survival with predicted outcomes. Logistic and linear regression analyses were performed to identify factors associated with survival gain.
Results: The median observed survival was 26.0 months, compared with a model‐predicted survival of 24.7 months. Treatment with atezolizumab plus bevacizumab was significantly associated with survival exceeding model predictions (odds ratio: 3.77, p = 0.0065). Linear regression analysis confirmed that atezolizumab plus bevacizumab was independently associated with a greater survival benefit (β = 0.192, p = 0.0084). Subgroup analysis demonstrated that this association was particularly pronounced in patients with high tumor burden (tumor number plus size ≥ 11), whereas no significant associations were observed for lenvatinib, STRIDE, or cabozantinib.
Conclusions: Atezolizumab plus bevacizumab was associated with survival beyond that predicted by a prognostic model in patients with BCLC‐B2 stage hepatocellular carcinoma, particularly those with high tumor burden. These findings should be considered exploratory and associative rather than evidence of a causal treatment effect.
Related
- Atezolizumab plus Bevacizumab with or without Transarterial Chemoembolization as First-Line Treatment for Barcelona Clinic Liver Cancer Stage C Hepatocellular Carcinoma: A Nationwide Multicenter Retrospective Study.
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- Acute colonic variceal bleeding treated with coil-assisted retrograde transvenous obliteration following atezolizumab-bevacizumab therapy for advanced hepatocellular carcinoma: A case report.
- Real-world evidence for atezolizumab with bevacizumab for unresectable hepatocellular carcinoma: a multicentre UK Midlands cohort
- Prognostic Significance of Response Dynamics in Atezolizumab plus Bevacizumab-Treated Hepatocellular Carcinoma: A Multicenter Real-World Validation Study.
BibTeX
@article{ouchi2026atezolizumab,
title = {{Atezolizumab Plus Bevacizumab Treatment for Patients With Hepatocellular Carcinoma in the Barcelona Clinic Liver Cancer B2 Stage}},
author = {Keishi Ouchi and Masashi Ninomiya and Mio Tsuruoka and Jun Inoue and Atsushi Hiraoka and Kosuke Sato and Kotaro Doi and Kengo Watanabe and Tomoya Sasazaki and Takayoshi Oikawa and Kei Endo and Tamami Abe and Masashi Fujita and Kazumichi Abe and Tomohiro Katsumi and Wataru Sato and Chikara Iino and Nobukazu Tanabe and Hiroshi Numao and Hiromasa Ohira and Hidekatsu Kuroda and Yoshiyuki Ueno and Atsushi Masamune},
journal = {Journal of Gastroenterology and Hepatology},
year = {2026},
month = sep,
doi = {10.1111/jgh.70765},
url = {https://doi.org/10.1111/jgh.70765},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Atezolizumab Plus Bevacizumab Treatment for Patients With Hepatocellular Carcinoma in the Barcelona Clinic Liver Cancer B2 Stage
AU - Keishi Ouchi
AU - Masashi Ninomiya
AU - Mio Tsuruoka
AU - Jun Inoue
AU - Atsushi Hiraoka
AU - Kosuke Sato
AU - Kotaro Doi
AU - Kengo Watanabe
AU - Tomoya Sasazaki
AU - Takayoshi Oikawa
AU - Kei Endo
AU - Tamami Abe
AU - Masashi Fujita
AU - Kazumichi Abe
AU - Tomohiro Katsumi
AU - Wataru Sato
AU - Chikara Iino
AU - Nobukazu Tanabe
AU - Hiroshi Numao
AU - Hiromasa Ohira
AU - Hidekatsu Kuroda
AU - Yoshiyuki Ueno
AU - Atsushi Masamune
PY - 2026
DA - 2026/09/28
JO - Journal of Gastroenterology and Hepatology
DO - 10.1111/jgh.70765
UR - https://doi.org/10.1111/jgh.70765
AB - Background and Aim: The optimal treatment strategy for patients with intermediate‐stage hepatocellular carcinoma beyond the up‐to‐seven criteria (Barcelona Clinic Liver Cancer B2) remains uncertain. Although transarterial chemoembolization has long been the standard of care, its efficacy is limited in this subgroup, and systemic therapies have recently been introduced. We aimed to explore treatment modalities associated with survival beyond that predicted by a previously validated prognostic model. Methods: We retrospectively analyzed 113 patients diagnosed with BCLC‐B2 stage hepatocellular carcinoma between 2017 and 2024. Predicted survival was calculated using a previously established prognostic model, and treatment benefits were evaluated by comparing observed survival with predicted outcomes. Logistic and linear regression analyses were performed to identify factors associated with survival gain. Results: The median observed survival was 26.0 months, compared with a model‐predicted survival of 24.7 months. Treatment with atezolizumab plus bevacizumab was significantly associated with survival exceeding model predictions (odds ratio: 3.77, p = 0.0065). Linear regression analysis confirmed that atezolizumab plus bevacizumab was independently associated with a greater survival benefit (β = 0.192, p = 0.0084). Subgroup analysis demonstrated that this association was particularly pronounced in patients with high tumor burden (tumor number plus size ≥ 11), whereas no significant associations were observed for lenvatinib, STRIDE, or cabozantinib. Conclusions: Atezolizumab plus bevacizumab was associated with survival beyond that predicted by a prognostic model in patients with BCLC‐B2 stage hepatocellular carcinoma, particularly those with high tumor burden. These findings should be considered exploratory and associative rather than evidence of a causal treatment effect.
SN - 0815-9319
SN - 1440-1746
ER -