Impact of Early-Line Systemic Therapies on Liver Function in Hepatocellular Carcinoma: Longitudinal Change of ALBI Score and Ammonia Level With and Without Anti-VEGF Agents.
1/5 보강
PICO 자동 추출 (휴리스틱, conf 2/4)
유사 논문P · Population 대상 환자/모집단
223 patients with HCC who received systemic therapy for more than 10 weeks at Kindai University Hospital between November 2013 and May 2024 with lenvatinib (n = 94), atezolizumab plus bevacizumab (n = 87), or pure immunotherapy without anti-VEGF agents (n = 42).
I · Intervention 중재 / 시술
추출되지 않음
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
Older age (lenvatinib) and elevated baseline ALT (atezolizumab plus bevacizumab) are risk factors for hepatic functional decline. Careful patient selection and management tailored to age and baseline inflammatory markers is required to minimize adverse liver outcomes and preserve treatment continuity.
[BACKGROUND AND AIM] Anti-vascular endothelial growth factor (VEGF) agents are widely used for hepatocellular carcinoma (HCC); inhibition of VEGF-mediated liver regeneration may compromise hepatic res
- 표본수 (n) 94
- p-value p = 0.0187
- p-value p = 0.0307
APA
Nishida N, Ueshima K, et al. (2026). Impact of Early-Line Systemic Therapies on Liver Function in Hepatocellular Carcinoma: Longitudinal Change of ALBI Score and Ammonia Level With and Without Anti-VEGF Agents.. Hepatology research : the official journal of the Japan Society of Hepatology. https://doi.org/10.1111/hepr.70126
MLA
Nishida N, et al.. "Impact of Early-Line Systemic Therapies on Liver Function in Hepatocellular Carcinoma: Longitudinal Change of ALBI Score and Ammonia Level With and Without Anti-VEGF Agents.." Hepatology research : the official journal of the Japan Society of Hepatology, 2026.
PMID
41581016 ↗
Abstract 한글 요약
[BACKGROUND AND AIM] Anti-vascular endothelial growth factor (VEGF) agents are widely used for hepatocellular carcinoma (HCC); inhibition of VEGF-mediated liver regeneration may compromise hepatic reserve. We investigated the impact of anti-VEGF therapy on liver function and risk factors for deterioration of albumin-bilirubin (ALBI) score during the treatment.
[METHODS] We retrospectively analyzed 223 patients with HCC who received systemic therapy for more than 10 weeks at Kindai University Hospital between November 2013 and May 2024 with lenvatinib (n = 94), atezolizumab plus bevacizumab (n = 87), or pure immunotherapy without anti-VEGF agents (n = 42). Liver function was monitored for ≥ 24 weeks using ALBI score and percentage changes from baseline in serum albumin, bilirubin, and ammonia levels (ΔALB, ΔBil, and ΔNH3). Multivariable logistic regression identified risk factors for the worsening of ALBI ≥ 0.4.
[RESULTS] ALBI scores worsened significantly from week 2 with lenvatinib and from week 8 with atezolizumab plus bevacizumab, whereas pure immunotherapy showed no significant change. Ammonia elevations were also significant with lenvatinib. In multivariable analyses, older age among lenvatinib cohort and higher baseline alanine aminotransferase (ALT) among atezolizumab plus bevacizumab cohort were independently associated with ALBI deterioration at 24 weeks (p = 0.0187 and p = 0.0307, respectively).
[CONCLUSION] Treatment that include anti-VEGF agents can substantially worsen ALBI scores and lenvatinib additionally increases ammonia levels. Older age (lenvatinib) and elevated baseline ALT (atezolizumab plus bevacizumab) are risk factors for hepatic functional decline. Careful patient selection and management tailored to age and baseline inflammatory markers is required to minimize adverse liver outcomes and preserve treatment continuity.
[METHODS] We retrospectively analyzed 223 patients with HCC who received systemic therapy for more than 10 weeks at Kindai University Hospital between November 2013 and May 2024 with lenvatinib (n = 94), atezolizumab plus bevacizumab (n = 87), or pure immunotherapy without anti-VEGF agents (n = 42). Liver function was monitored for ≥ 24 weeks using ALBI score and percentage changes from baseline in serum albumin, bilirubin, and ammonia levels (ΔALB, ΔBil, and ΔNH3). Multivariable logistic regression identified risk factors for the worsening of ALBI ≥ 0.4.
[RESULTS] ALBI scores worsened significantly from week 2 with lenvatinib and from week 8 with atezolizumab plus bevacizumab, whereas pure immunotherapy showed no significant change. Ammonia elevations were also significant with lenvatinib. In multivariable analyses, older age among lenvatinib cohort and higher baseline alanine aminotransferase (ALT) among atezolizumab plus bevacizumab cohort were independently associated with ALBI deterioration at 24 weeks (p = 0.0187 and p = 0.0307, respectively).
[CONCLUSION] Treatment that include anti-VEGF agents can substantially worsen ALBI scores and lenvatinib additionally increases ammonia levels. Older age (lenvatinib) and elevated baseline ALT (atezolizumab plus bevacizumab) are risk factors for hepatic functional decline. Careful patient selection and management tailored to age and baseline inflammatory markers is required to minimize adverse liver outcomes and preserve treatment continuity.