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Comparing the impact of atezolizumab plus bevacizumab and lenvatinib on the liver function in hepatocellular carcinoma patients: A mixed-effects regression model approach.
Hatanaka et al., Cancer Med 2023
DOI: 10.1002/cam4.6726
Ho ho ho! Gather ’round, my friends, as we delve into a tale of medical research, as fascinating as the twinkling lights on a Christmas tree. This story revolves around a retrospective study, comparing the effects of two treatments, atezolizumab plus bevacizumab (Atez/Bev) and lenvatinib (LEN), on the liver function of patients with hepatocellular carcinoma. Just like Santa’s list, this study included a hefty number of patients – 526 who received Atez/Bev and 731 who received LEN between March 2018 and July 2022.
With the precision of elves wrapping presents, a 1:1 propensity-score-matched analysis was conducted, identifying 324 patients in each group for the analysis. Nonlinear mixed-effects regression models were used, as flexible as Rudolph’s flight path, allowing for the inclusion of cases where treatment was interrupted due to disease progression, adverse events, or loss to follow-up. These models were used to compare the ALBI score between the Atez/Bev and LEN groups.
After the matching, akin to sorting out the naughty and nice list, the mean ALBI scores in the Atez/Bev and LEN groups were quite similar at baseline and at 12 weeks. Although the ALBI score significantly worsened during treatment in both groups (as unexpected as a lump of coal in a stocking), there was no significant difference in the rate of ALBI score deterioration between the groups.
However, like a surprise gift under the tree, subgroup analyses revealed that LEN-treated patients with BCLC advanced stage and those who initially received the full dose had a significantly greater worsening of ALBI score compared to Atez/Bev.
So, in the end, like the calm after a successful Christmas Eve delivery, this study found no significant difference in the trend of liver function deterioration between the Atez/Bev and LEN groups. But a word of caution, like leaving out milk and cookies for Santa, should be exercised for LEN-treated patients with BCLC advanced stage or those receiving the full dose of LEN. Ho ho ho!