Article Dans Une Revue European Journal of Gastroenterology & Hepatology Année : 2023

Unresectable hepatocellular carcinoma at dawn of immunotherapy era: real-world data from the French prospective CHIEF cohort

1 Service d'Hépato Gastroenterologie [CHU Amiens-Picardie]
2 GRAP - Groupe de Recherche sur l'alcool et les pharmacodépendances - UMR INSERM_S 1247 UPJV
3 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers
4 CHIMERE - CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516
5 Service d'Hépatologie et de Gastroentérologie [Lyon]
6 U955 Inserm - UPEC - IMRB - VHC/"Viruses-Hepatology-Cancers" [Créteil]
7 CHU Henri Mondor [Créteil]
8 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
9 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
10 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
11 INFINITE - Institute for Translational Research in Inflammation - U 1286
12 C3M - Centre méditerranéen de médecine moléculaire
13 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
14 IAB - Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble)
15 Service d'hépato-gastroentérologie [CHU Grenoble Alpes]
16 Service d'Hépato-Gastroentérologie [CHU Rouen]
17 Hôpital Beaujon [AP-HP]
18 CHSF - Centre Hospitalier Sud Francilien - Centre Hospitalier d'Evry
19 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
20 Service d'Hépato-gastro-entérologie [CHRU Nancy]
21 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
22 Hôpital Paul Brousse
23 Roche France
24 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
Mélina Gilberg
  • Fonction : Auteur
Alexandre Tanang
  • Fonction : Auteur
Julien Dupin
  • Fonction : Auteur

Résumé

Background and objectives Hepatocellular carcinoma epidemiological data are limited in France. The Epidemio Liver Immunotherapy Tecentriq outcome research (ELITor) retrospective study, based on real-world data from the Carcinome HépatocellulaIrE en France (CHIEF) French cohort of hepatocellular carcinoma patients, aimed to get insight into the treatment patterns, the sociodemographic, clinical, biological, and etiological characteristics, and the quality of life of patients with unresectable hepatocellular carcinoma. Methods and results Between 1 September 2019 and 4 December 2020, 367 patients from the CHIEF cohort received at least one locoregional (52.8%) chemoembolization or radioembolization or systemic treatment (88.3%) and were selected for ELITor. Most patients had a Barcelona Clinic Liver Cancer (BCLC) C (93.2%) hepatocellular carcinoma stage and were affected by cirrhosis (67.7%). Alcohol was confirmed as the main etiology both as a single etiology (29.1%) and in association with other risk factors (26.9%), mainly metabolic disorders (16.2%). Tyrosine-kinase inhibitors, mainly sorafenib, were the most administered systemic treatments in first line. Patients who received at least one combination of atezolizumab and bevacizumab during the study period ( N = 53) had a better performance status and less portal hypertension frequency than the overall population and more hepatitis B virus infection and fewer metabolic disorders as single etiology. Overall, the global health score before treatment (62.3 ± 21.9) was in line with that of reference cancer patients and worsened in 51.9% of the cases after first-line palliative-intent treatment. Conclusion This study provided real-life data on advanced hepatocellular carcinoma characteristics and treatment patterns and described the first patients to receive the atezolizumab-bevacizumab combination before it became the new standard of care for advanced hepatocellular carcinoma.

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Dates et versions

hal-04182844 , version 1 (18-08-2023)

Identifiants

Citer

Eric Nguyen-Khac, Pierre Nahon, Olivier Ganry, Hajer Ben Khadhra, Philippe Merle, et al.. Unresectable hepatocellular carcinoma at dawn of immunotherapy era: real-world data from the French prospective CHIEF cohort. European Journal of Gastroenterology & Hepatology, 2023, 35 (10), pp.1168-1177. ⟨10.1097/MEG.0000000000002546⟩. ⟨hal-04182844⟩
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