{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T19:20:08Z","timestamp":1780082408555,"version":"3.54.0"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T00:00:00Z","timestamp":1710288000000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Atezolizumab plus bevacizumab combination therapy (Atezo + Beva) is used as the first\u2010line therapy for unresectable hepatocellular carcinoma (u\u2010HCC). Serious adverse events (AEs), including rupture of esophagogastric varices, have been seen during treatment. Therefore, the relationships of efficacy, safety, and portal hypertension (PH) were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 146 patients with u\u2010HCC and Child\u2010Pugh Scores of 5\u20137 received Atezo + Beva. Prophylactic treatment for varices was performed for patients with the risk of rupture of varices before the start of Atezo + Beva. A propensity score\u2010matched cohort was created to minimize the risk of potential confounders. Efficacy was assessed in 41 propensity score\u2010matched pairs. AEs were assessed between patients without PH (<jats:italic>n<\/jats:italic>\u2009=\u200980) and with PH (<jats:italic>n<\/jats:italic>\u2009=\u200966).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In patients without PH and with PH, median overall survival was 18.4\u2009months and 18.8\u2009months (<jats:italic>p<\/jats:italic>\u2009=\u20090.71), and median progression\u2010free survival was 8.6\u2009months and 5.8\u2009months (<jats:italic>p<\/jats:italic>\u2009=\u20090.92), respectively. On the best radiological response evaluation for Response Evaluation Criteria in Solid Tumors, the objective response rate was 31.7% and 26.8% (<jats:italic>p<\/jats:italic>\u2009=\u20090.81), respectively. Variceal rupture occurred in three patients with PH, but there were no significant differences in the occurrence of variceal rupture (<jats:italic>p<\/jats:italic>\u2009=\u20090.090) and Grade 3\u20134 AEs between patients without and with PH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>No significant differences in efficacy and safety were observed with PH. Prophylactic treatment for varices before the start of Atezo + Beva would allow treatment to continue relatively safely.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.7025","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T12:28:44Z","timestamp":1710332924000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy and safety of atezolizumab plus bevacizumab in patients with portal hypertension for unresectable hepatocellular carcinoma"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8322-4885","authenticated-orcid":false,"given":"Takahiro","family":"Kinami","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima 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