CRAFITYスコア別にみた、肝細胞癌の一次治療としてのAtezo+Bev療法とレンバチニブ療法の比較:国際共同研究

腫瘍内科は、患者さんの人生に寄り添い、さまざまな経験や感情を共有することのできる、非常に魅力的な診療科です。常に医学の進歩を実感でき、研究成果がただちに患者さんの幸福につながっていく様子を体感できるのも腫瘍内科ならではだと思います。

腫瘍内科に携わる医療者は他人の幸せをみるのが好きな人たちばかりなので、自然と居心地の良いコミュニティが出来上がります。

ぜひ腫瘍内科の世界に足を踏み出してみてください！

Atezo+Bev vs. LEN as First-line Treatment for HCC Stratified by the CRAFITY Score: An International Collaborative Study

[Background]

Atezolizumab plus bevacizumab (Atezo+Bev) is the most widely used first-line treatment for unresectable hepatocellular carcinoma (HCC), while lenvatinib (LEN) is another standard option. We previously reported that the efficacy of Atezo+Bev is limited in Japanese HCC patients with a CRAFITY score of 2 (CRP ≥1 mg/dL and AFP ≥100 ng/mL). Therefore, we conducted an international collaborative study to compare the efficacy of Atezo+Bev and LEN stratified by the baseline CRAFITY score.

[Methods]

We retrospectively analyzed 994 patients who initiated Atezo+Bev or LEN as first-line treatment for unresectable HCC between September 2017 and March 2024 across 11 hospitals in Japan and 15 hospitals in Taiwan. Patients were categorized by baseline CRAFITY score, and progression-free survival (PFS) and overall survival (OS) were compared between the two groups.

[Results]

The median age was 71 years, and 770 patients (77.5%) were male. The baseline CRAFITY score was 0 in 375 patients (37.7%), 1 in 402 patients (40.4%), and 2 in 217 patients (21.8%). In CRAFITY-0 patients, median PFS (10.8 vs. 9.4 months; p = 0.548) and OS (21.1 vs. 29.3 months; p = 0.074) did not differ significantly. Similar findings were observed in CRAFITY-1 patients, with median PFS of 6.0 vs. 6.1 months (p = 0.943) and OS of 12.7 vs. 15.1 months (p = 0.168). In contrast, among CRAFITY-2