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Background <p>Hepatocellular carcinoma (HCC) remains a major cause of cancer-related mortality worldwide. Atezolizumab combined with bevacizumab is the current first-line standard for advanced HCC, but its performance in real-world settings warrants further exploration.</p> Methods <p>We conducted a retrospective, multicenter study involving 80 patients treated between January 2022 and January 2024 across four Italian oncology centers. The primary objectives were early mortality and treatment discontinuation. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and safety profile.</p> Results <p>Early mortality occurred in 41.2% of patients. MELD score &gt; 11 was the only independent predictor of early death (OR: 17.52, <i>p</i> &lt; 0.001), while ECOG ≥ 2 did not retain significance in multivariate analysis. Treatment discontinuation was infrequent (5%), and the combination therapy was generally well tolerated.</p> Conclusions <p>MELD &gt; 11 strongly predicted early mortality in this real-world cohort, highlighting the importance of accurate liver function assessment before treatment initiation. These findings suggest that MELD may be a valuable tool in guiding therapeutic decisions for advanced HCC in routine clinical practice.</p>

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Real-world Predictors of Early Mortality and Treatment Discontinuation in HCC Patients Treated with Atezolizumab–Bevacizumab

  • 期刊论文

  • 发表日期：

    2026年1月20日

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  • Palma Fedele,
  • Matteo Landriscina,
  • Antonio Di Stasi,
  • Arianna Gadaleta-Caldarola,
  • Guido Giordano,
  • Vincenzo Emanuele Chiuri,
  • Mariachiara Masucci,
  • Giulia Villano,
  • Rosaria Martina,
  • Federica Fumai,
  • Giovanni Santacroce,
  • Angelo Nacci,
  • Antonella Licchetta,
  • Vincenzo Dadduzio,
  • Gennaro Gadaleta-Caldarola

摘要

Background

Hepatocellular carcinoma (HCC) remains a major cause of cancer-related mortality worldwide. Atezolizumab combined with bevacizumab is the current first-line standard for advanced HCC, but its performance in real-world settings warrants further exploration.

Methods

We conducted a retrospective, multicenter study involving 80 patients treated between January 2022 and January 2024 across four Italian oncology centers. The primary objectives were early mortality and treatment discontinuation. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and safety profile.

Results

Early mortality occurred in 41.2% of patients. MELD score > 11 was the only independent predictor of early death (OR: 17.52, p < 0.001), while ECOG ≥ 2 did not retain significance in multivariate analysis. Treatment discontinuation was infrequent (5%), and the combination therapy was generally well tolerated.

Conclusions

MELD > 11 strongly predicted early mortality in this real-world cohort, highlighting the importance of accurate liver function assessment before treatment initiation. These findings suggest that MELD may be a valuable tool in guiding therapeutic decisions for advanced HCC in routine clinical practice.