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Background <p>Increasing evidence indicates that vitamin D has anticancer effects. However, there are very limited data regarding the relationship between vitamin D levels and the efficacy or prognosis by atezolizumab plus bevacizumab (ATZ/BEV) for hepatocellular carcinoma (HCC). We sought to investigate this.</p> Methods <p>This study included 142 HCC patients who were treated with ATZ/BEV as the first-line of systemic chemotherapy. Their initial treatment responses were evaluated using dynamic computed tomography or magnetic resonance imaging. Serum levels of 25-hydroxyvitamin D (vitamin D) were measured before treatment, and their associations with treatment efficacy and prognosis were analyzed.</p> Results <p>Pretreatment vitamin D levels tended to be lower in patients who showed progressive disease (PD) at the initial response assessment than in those without PD (<i>P</i> = 0.098). Receiver operating curve analysis of pretreatment serum vitamin D levels for discriminating non-PD and PD at the initial therapeutic response yielded an area under the curve of 0.611, and the optimal cutoff value was determined to be 17.8 ng/mL. In addition, this cutoff value effectively stratified patients according to overall survival (OS) (high vs. low: not reached vs. 27.0&#xa0;months, <i>P</i> = 0.022). Multivariate analysis showed that modified albumin–bilirubin grade (≥ 2a) (HR = 2.06; <i>P</i> = 0.018) and high serum vitamin D levels (≥ 17.8 ng/ml) (HR = 0.58; <i>P</i> = 0.046) were independently associated with OS.</p> Conclusions <p>Serum vitamin D levels before treatment may serve as a predictive biomarker for the prognosis in patients treated with ATZ/BEV for advanced HCC.</p>

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Pretreatment serum vitamin D levels predict the therapeutic efficacy of atezolizumab plus bevacizumab therapy in advanced hepatocellular carcinoma: a multicenter analysis

  • 期刊论文

  • 发表日期：

    2026年6月27日

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  • Takanori Suzuki,
  • Kentaro Matsuura,
  • Satoshi Narahara,
  • Kohei Okayama,
  • Fumihiro Okumura,
  • Satoshi Sobue,
  • Kiyoto Narita,
  • Tsutomu Mizoshita,
  • Hiromu Kondo,
  • Yoshihide Kimura,
  • Daisuke Kato,
  • Katsumi Hayashi,
  • Haruki Uojima,
  • Mayumi Hojo,
  • Shuko Murakami,
  • Takako Inoue,
  • Hayato Kawamura,
  • Kei Fujiwara,
  • Shunsuke Nojiri,
  • Hiromi Kataoka,
  • Yasuhito Tanaka

摘要

Background

Increasing evidence indicates that vitamin D has anticancer effects. However, there are very limited data regarding the relationship between vitamin D levels and the efficacy or prognosis by atezolizumab plus bevacizumab (ATZ/BEV) for hepatocellular carcinoma (HCC). We sought to investigate this.

Methods

This study included 142 HCC patients who were treated with ATZ/BEV as the first-line of systemic chemotherapy. Their initial treatment responses were evaluated using dynamic computed tomography or magnetic resonance imaging. Serum levels of 25-hydroxyvitamin D (vitamin D) were measured before treatment, and their associations with treatment efficacy and prognosis were analyzed.

Results

Pretreatment vitamin D levels tended to be lower in patients who showed progressive disease (PD) at the initial response assessment than in those without PD (P = 0.098). Receiver operating curve analysis of pretreatment serum vitamin D levels for discriminating non-PD and PD at the initial therapeutic response yielded an area under the curve of 0.611, and the optimal cutoff value was determined to be 17.8 ng/mL. In addition, this cutoff value effectively stratified patients according to overall survival (OS) (high vs. low: not reached vs. 27.0 months, P = 0.022). Multivariate analysis showed that modified albumin–bilirubin grade (≥ 2a) (HR = 2.06; P = 0.018) and high serum vitamin D levels (≥ 17.8 ng/ml) (HR = 0.58; P = 0.046) were independently associated with OS.

Conclusions

Serum vitamin D levels before treatment may serve as a predictive biomarker for the prognosis in patients treated with ATZ/BEV for advanced HCC.