{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T12:21:28Z","timestamp":1764937288970,"version":"3.40.5"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,8,8]],"date-time":"2021-08-08T00:00:00Z","timestamp":1628380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Hepatocellular carcinoma (HCC) is a common complication of chronic liver disease with diverse underlying aetiologies. REACH\/REACH\u20102 were global phase III studies investigating ramucirumab in advanced HCC (aHCC) following sorafenib treatment. We performed an exploratory analysis of outcomes by liver disease aetiology and baseline serum viral load.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Meta\u2010analysis was conducted in patients with aHCC and alpha\u2010fetoprotein (AFP) \u2265400\u00a0ng\/mL (N\u00a0=\u00a0542) from REACH\/REACH\u20102 trials. Individual patient\u2010level data were pooled with results reported by aetiology subgroup (hepatitis B [HBV] or C [HCV] and Other). Pre\u2010treatment serum HBV DNA and HCV RNA were quantified using Roche COBAS AmpliPrep\/COBAS TaqMan. Overall survival (OS) and progression\u2010free survival (PFS) were evaluated using the Kaplan\u2010Meier method and Cox proportional hazard model (stratified by study).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline characteristics were generally balanced between arms in each subgroup (HBV: N\u00a0=\u00a0225, HCV: N\u00a0=\u00a0127, Other: N\u00a0=\u00a0190). No significant difference in treatment effect by aetiology subgroup was detected (OS interaction <jats:italic>P<\/jats:italic>\u2010value = .23). Median OS (ramucirumab vs placebo) in months was 7.7 versus 4.5 (HR 0.74, 95% CI 0.55\u20130.99) for HBV, 8.2 versus 5.5 (HR 0.82, 95% CI 0.55\u20131.23) for HCV and 8.5 versus 5.4 (HR 0.56, 95% CI 0.40\u20130.79) for Other. Ramucirumab showed similar overall safety profiles across subgroups. Worst outcomes were noted in patients with a detectable HBV load. Use of HBV antiviral therapy, irrespective of viral load, was beneficial for survival, liver function and liver\u2010specific adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ramucirumab improved survival across aetiology subgroups with a tolerable safety profile, supporting its use in patients with aHCC and elevated AFP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14994","type":"journal-article","created":{"date-parts":[[2021,6,26]],"date-time":"2021-06-26T08:02:15Z","timestamp":1624694535000},"page":"2759-2767","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Ramucirumab in patients with previously treated advanced hepatocellular carcinoma: Impact of liver disease aetiology"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8294-0992","authenticated-orcid":false,"given":"Peter 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