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World Journal of Clinical Cases 2025年第9期13卷 56-59页

作者： Mina Tharwat Ahmed Tawheed Mohamed El-Kassas Department of Tropical Medicine and Gastroenterology Faculty of MedicineAswan UniversityAswan 81528Egypt Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt

Hepatocellular carcinoma(HCC)is the most prevalent cancer of the hepatobiliary tract and the third leading cause of cancer-related mortality *** and bevacizumab combination is currently considered among the frontline treatment modalities for advanced unresectable *** studies examining this combination were focused on evaluating its *** numerous case reports documenting some side effects,there is a limited number of large-scale studies assessing these side *** this article,we comment on the case report by Park et al published recently,reporting a fatal intra-tumoral hemorrhage in a patient with HCC who received systemic therapy in the form of the combination of atezolizumab and bevacizumab.

关键词： Hepatocellular carcinoma atezolizumab Bevacizumab Hemorrhage Side effects

atezolizumab-induced anaphylactic shock in a patient with hepatocellular carcinoma undergoing immunotherapy:A case report

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World Journal of Clinical Cases 2021年第16期9卷 4110-4115页

作者： Li-Fang Bian Chao Zheng Xiao-Lan Shi Department of Hepatobiliary and Pancreatic Surgery The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Gastrointestinal Surgery The First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310006Zhejiang ProvinceChina

BACKGROUND atezolizumab is a programmed death ligand 1(PD-L1)inhibitor,and its combination with bevacizumab has been proven an effective immunotherapy for unresectable hepatocellular carcinoma(HCC).Treatment with immune checkpoint inhibitors(ICIs)can lead to hypersensitivity reactions;however,anaphylactic shock is *** present a case of life-threatening anaphylactic shock during atezolizumab infusion and performed a relevant literature *** SUMMARY A 75-year-old man was diagnosed with HCC recurrence after *** was administered immunotherapy with atezolizumab plus bevacizumab after an allergy to a programmed death-1(PD-1)*** patient showed a sudden onset of dizziness,numbness,and lack of consciousness with severe hypotension during atezolizumab *** treatment was stopped *** patient’s symptoms resolved after 5 mg dexamethasone was *** of repeated hypersensitivity reactions to ICIs,treatment was changed to oral targeted regorafenib *** Further research is necessary for elucidating the hypersensitivity mechanisms and establishing standardized skin test and desensitization protocols associated with PD-1 and PD-L1 to ensure effective treatment with ICIs.

关键词： atezolizumab Immune checkpoint inhibitors Anaphylactic shock Hypersensitivity reaction Infusion reaction Hepatocellular carcinoma Case report

atezolizumab plus bevacizumab versus sorafenib as first-line treatment for unresectable hepatocellular carcinoma:a cost-effectiveness analysis

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Cancer Communications 2020年第12期40卷 743-745页

作者： Yanli Hou Bin Wu Department of Radiation Oncology Ren Ji HospitalSchool of MedicineShanghai Jiaotong UniversityShanghai 201112P.R.China Medical Decision and Economic Group Department of PharmacyRen Ji HospitalSouth CampusSchool of MedicineShanghai Jiaotong UniversityShanghai 201112P.R.China

Dear Editor,Liver cancer is the third leading cause of cancer deaths worldwide and accounted for 8.9%of all neoplasms,as shown by the Global Burden of Disease Study 2017[1].Hepatocellular carcinoma(HCC)comprises 75%-85%of liver cancers[2].The abysmal statistic is partly contributed by the fact that only 30%-40%of all patients are diagnosed at early stages that are amenable to potentially curative treatments[3].For over a decade,the availability of new agents,such as lenvatinib-and sorafenib-based targeted therapy,has significantly improved the outcome of patients with advanced HCC,prolonging the median overall survival(OS)from 4-8 months to 10-15 months[4,5].However,the therapeutic options for advanced HCC are still limited,and the prognosis is poor.

关键词： Hepatocellular carcinoma atezolizumab Bevacizumab Sorafenib Cost-effectiveness

IMpower210:A phase Ⅲ study of second-line atezolizumab vs. docetaxel in East Asian patients with non-small cell lung cancer

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Chinese Journal of Cancer Research 2024年第2期36卷 103-113页

作者： Yi-Long Wu Shun Lu Gongyan Chen Jianxing He Jifeng Feng Yiping Zhang Liyan Jiang Hongming Pan Jianhua Chang Jian Fang Amy Cai Lilian Bu Jane Shi Jinjing Xia Guangdong Lung Cancer Institute Guangdong Provincial Key Laboratory of Translational Medicine in Lung CancerGuangdong Provincial People's Hospital&Guangdong Academy of Medical SciencesSouthern Medical UniversityGuangzhou 510080China Shanghai Lung Cancer Center Shanghai Chest HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200025China Department of Respiration Harbin Cancer HospitalHarbin Medical UniversityHarbin 150081China Department of Thoracic Oncology and Surgery the First Affliated Hospital of Guangzhou Medical UniversityGuangzhou 510120China Department of Medical Oncology Jiangsu Cancer HospitalNanjing 210009China Department of Medical Oncology Zhejiang Cancer HospitalHangzhou 330022China Department of Pulmonary Medicine Shanghai Chest HospitalShanghai Jiao Tong UniversityShanghai 200030China Department of Medical Oncology Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China Department of Medical Oncology Shenzhen HospitalCancer Hospital of Chinese Academy of Medical SciencesShenzhen 518116China Department of Thoracic Oncology Beijing Cancer HospitalBeijing 100142China Product Development Shanghai Roche Pharmaceutical LtdShanghai 201203China

Objective: IMpower210(NCT02813785) explored the efficacy and safety of single-agent atezolizumab *** as second-line treatment for advanced non-small cell lung cancer(NSCLC) in East Asian ***: Key eligibility criteria for this phase Ⅲ, open-label, randomized study included age ≥18 years;histologically documented advanced NSCLC per the Union for International Cancer Control/American Joint Committee on Cancer staging system(7th edition);Eastern Cooperative Oncology Group performance status of 0 or 1;and disease progression following platinum-based chemotherapy for advanced or metastatic NSCLC. Patients were randomized 2:1 to receive either atezolizumab(1,200 mg) or docetaxel(75 mg/m^(2)). The primary study endpoint was overall survival(OS) in the intention-to-treat(ITT) population with wild-type epidermal growth factor receptor expression(ITT EGFR-WT) and in the overall ITT ***: Median OS in the ITT EGFR-WT population(n=467) was 12.3 [95% confidence interval(95% CI),10.3-13.8] months in the atezolizumab arm(n=312) and 9.9(95% CI, 7.8-13.9) months in the docetaxel arm[n=155;stratified hazard ratio(HR), 0.82;95% CI, 0.66-1.03]. Median OS in the overall ITT population was 12.5(95% CI, 10.8-13.8) months with atezolizumab treatment and 11.1(95% CI, 8.4-14.2) months(n=377) with docetaxel treatment(n=188;stratified HR, 0.87;95% CI, 0.71-1.08). Grade 3/4 treatment-related adverse events(TRAEs) occurred in 18.4% of patients in the atezolizumab arm and 50.0% of patients in the docetaxel ***: IMpower210 did not meet its primary efficacy endpoint of OS in the ITT EGFR-WT or overall ITT populations. atezolizumab was comparatively more tolerable than docetaxel, with a lower incidence of grade3/4 TRAEs.

关键词： atezolizumab East Asia non-small cell lung cancer programmed death-ligand 1 inhibitors monoclonal antibody

atezolizumab and bevacizumab as first line therapy in advanced hepatocellular carcinoma:Practical considerations in routine clinical practice

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World Journal of Hepatology 2021年第9期13卷 1132-1142页

作者： Ankit Jain Shivakumar Chitturi Geoffrey Peters Desmond Yip Department of Medical Oncology The Canberra HospitalGarran 2605ACTAustralia ANU Medical School Australian National UniversityCanberra 0200ACTAustralia Gastroenterology and Hepatology Unit Canberra HospitalCanberra 2605ACTAustralia

Hepatocellular carcinoma(HCC)is the most common primary liver *** advanced HCC,sorafenib was considered the standard of care for more than ten *** the atezolizumab and bevacizumab combination has become standard of care for these patients without contraindications to either immune checkpoint inhibitors or antiangiogenic *** now review the practical aspects of the atezolizumab and bevacizumab combination,including current evidence,indications,contraindications,management of adverse events,sequencing of this combination,areas of current knowledge gaps and future areas of active clinical research of this combination for busy clinicians in clinical practice.

关键词： Hepatocellular carcinoma atezolizumab Bevacizumab Immunotherapy Child Pugh cirrhosis Anti-angiogenic therapy

Acute respiratory distress syndrome and severe pneumonitis after atezolizumab plus bevacizumab for hepatocellular carcinoma treatment:A case report

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World Journal of Gastrointestinal Oncology 2023年第5期15卷 892-901页

作者： Su Hyeon Cho Ga Ram You Chan Park Sang-Geon Cho Jong Eun Lee Sung Kyu Choi Sung Bum Cho Jae Hyun Yoon Department of Gastroenterology and Hepatology Chonnam National University Hospital and Medical SchoolGwangju 61469South Korea Department of Gastroenterology and Hepatology Hwasun Chonnam National University Hospital and Medical SchoolHwasun 58128South Korea Department of Radiology Chonnam National University Hospital and Medical SchoolGwangju 61469South Korea Department of Nuclear Medicine Chonnam National University HospitalHwasun 58128South Korea

BACKGROUND Hepatocellular carcinoma(HCC)is one of the most common cancers worldwide and has a high ***,the treatment options for advanced HCC are limited to tyrosine kinase inhibitors,such as sorafenib and *** previous regimens have an insufficient efficacy,the combination therapy of atezolizumab and bevacizumab(Ate/Bev)has been investigated,which showed an improvement in progression-free and overall ***,the adverse events of this combination therapy in advanced HCC have not been ***,we report a novel case of an unresectable HCC and acute respiratory distress syndrome(ARDS)after a combination therapy of Ate/*** SUMMARY An 82-year-old male visited our outpatient clinic for an incidentally detected liver *** magnetic resonance imaging and enhanced chest computed tomography(CT)were performed,which showed arterial hyperenhancement with washout in delayed phase suggesting HCC,and a well-defined metastatic solid nodule,respectively.F-18 fluorodeoxyglucose positron emission tomography(PET)-CT exhibited multiple hypermetabolic lesions in the iliac bone,lumbar vertebrae,and *** of the high burden of the intrahepatic tumor,transarterial radioembolization was initially performed;after 37 d,a combination therapy of Ate/Bev was *** patient visited the emergency department three days after Ate/Bev treatment complaining of *** was diagnosed with severe pneumonitis based on *** administering oxygen via a high-flow nasal cannula,the P/F ratio was only 74;therefore,the patient was diagnosed with ARDS based on the overall examination *** tidal volume with high positive end-expiratory pressure,sedative agents combined with a neuromuscular blocker,and a systemic steroid were promptly applied to manage the ***,the patient did not recover from the hypoxia and expired 31 h after being *** Clinicians should be aware of severe pneumonitis due to the immune-

关键词： Hepatocellular carcinoma Systemic therapy Adverse events Pneumonitis atezolizumab Acute respiratory distress syndrome

Clinical outcomes of atezolizumab in combination with etoposide/platinum for treatment of extensive-stage small-cell lung cancer:A real-world,multicenter,retrospective,controlled study in China

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Chinese Journal of Cancer Research 2022年第4期34卷 353-364页

作者： Hanxiao Chen Xiangjuan Ma Jie Liu Yu Yang Yong Fang Liping Wang Jian Fang Jun Zhao Minglei Zhuo Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department I of Thoracic OncologyPeking University Cancer Hospital&InstituteBeijing 100142China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department II of Thoracic OncologyPeking University Cancer Hospital&InstituteBeijing 100142China Department of Pneumology Shandong Cancer Hospital and InstituteShandong First Medical University and Shandong Academy of Medical SciencesJinan 250117China Department of Oncology the 2nd Affiliated Hospital of Harbin Medical UniversityHarbin 150001China Department of Oncology Sir Run Run Shaw Hospital Zhejiang University School of MedicineHangzhou 310020China Department of Oncology Baotou Cancer HospitalBaotou 014030China

Objective:atezolizumab along with chemotherapy has prolonged the survival of patients with extensive-stage small-cell lung cancer(ES-SCLC)worldwide,although real-world(RW)data are lacking in *** study was designed to evaluate the efficacy and clinical outcomes of atezolizumab plus etoposide/platinum(EP).Methods:Data obtained in this retrospective study were captured from six oncology units of five medical facilities from January 2019 to April *** first-line treatments,atezolizumab combined with EP *** alone,we primarily evaluated progression-free survival(PFS);other efficacy indicators,including overall survival(OS),objective response rate(ORR),and patterns of SCLC progression and adverse events(AEs)were ***:The primary analysis included data from 225 patients,of whom 133 received EP along with atezolizumab(atezolizumab group)and 92 received EP alone(EP group).The PFS duration of the atezolizumab group[7.10 months;95%confidence interval(95%CI),6.53-9.00]exceeded that of the EP group(6.50 months;95%CI,4.83-7.53).Overall,the hazard ratio(HR)was 0.69(95%CI,0.49-0.97)(P=0.029);particularly,the HR was 0.54(95%CI,0.36-0.80)among patients undergoing≥4 chemotherapy cycles and 0.33(95%CI,0.20-0.56)among individuals with atezolizumab *** ORR and disease-control rate(DCR)were similar between the two *** of incomplete OS data,the median OS was not determined for either *** marrow suppression was the most common AE detected(58.6%)in the atezolizumab ***-related AEs occurred in 19 patients in the atezolizumab group(14.3%),with only one case of grade 3 ***:This RW study in China demonstrated improved clinical outcomes of atezolizumab along with EP for ES-SCLC,particularly in the chemosensitive *** results align with the results of the IMpower133 study,although the impact of this treatment modality on OS warrants additional follow-up studies.

关键词： Real-world study extensive-stage SCLC atezolizumab

Massive bleeding from a gastric artery pseudoaneurysm in hepatocellular carcinoma treated with atezolizumab plus bevacizumab: A case report

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World Journal of Gastrointestinal Surgery 2023年第6期15卷 1232-1239页

作者： Fu-Wen Pang Bin Chen De-Ti Peng Jian He Wei-Cheng Zhao Tuan-Tuan Chen Zong-Gui Xie Hai-Hui Deng Department of Interventional Radiology Shenzhen Traditional Chinese Medicine HospitalShenzhen 518033Guangdong ProvinceChina Department of Hepatology Shenzhen Traditional Chinese Medicine HospitalShenzhen 518033Guangdong ProvinceChina

BACKGROUND The combination of atezolizumab(ATZ)and bevacizumab(BVZ)was approved as first-line systemic therapy for advanced hepatocellular carcinoma(HCC)owing to its superior rates of response and patient ***,ATZ+BVZ is associated with increased risk of upper gastrointestinal(GI)bleeding,including arterial bleeding,which is rare and potentially *** present a case of massive upper GI bleeding from a gastric pseudoaneurysm in a patient with advanced HCC who had been treated with ATZ+*** SUMMARY A 67-year-old man presented with severe upper GI bleeding after atezolizumab(ATZ)+bevacizumab(BVZ)therapy for *** failed to detect the bleeding *** subtraction angiography revealed a gastric artery pseudoaneurysm and contrast extravasation from the inferior splenic artery and a branch of the left gastric *** hemostasis was achieved with *** HCC patients who have been treated with ATZ+BVZ should be followed for 3 to 6 mo to monitor for development of massive GI *** may require *** is an effective treatment.

关键词： atezolizumab Bevacizumab Hepatocellular carcinoma Gastric artery pseudoaneurysm Gastrointestinal bleeding Case report

A Patient with atezolizumab-Induced Autoimmune Diabetes Mellitus Presenting with Diabetic Ketoacidosis

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Cardiovascular Innovations and Applications 2021年第3期6卷 45-50页

作者： Sharen Lee Gary Tse Cardiovascular Analytics Group Laboratory of Cardiovascular PhysiologyHong KongHKGChina Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease Department of CardiologyTianjin Institute of CardiologySecond Hospital of Tianjin Medical UniversityTianjin300211China Xiamen Cardiovascular Hospital Xiamen UniversityXiamen361015China

Background:atezolizumab,an immune checkpoint inhibitor,is a humanized monoclonal,anti-programmed death ligand 1(PD-L1)antibody used for the treatment of metastatic urothelial carcinoma that has progressed after *** Presentation:We describe a patient with a known history of urothelial carcinoma who presented with dia-betic ketoacidosis 6 weeks following his second cycle of *** serum lactate level was slightly elevated(2 mM)and hisβ-hydroxybutyrate level was elevated(3.9 mM).High anion gap metabolic acidosis secondary to dia-betic ketoacidosis was *** testing demonstrated hemoglobin A 1c level of 9.9%,positivity for anti-glutamic acid decarboxylase antibody(0.03 nM,reference rangeatezolizumab treatment,intravenous sodium chloride administration,and insulin pump infusion,after which metabolic acidosis gradually *** insulin pump was subsequently switched to Protaphane at 18 units before breakfast and 8 units before dinner,together with metformin at 1000 mg twice *** weeks later his medication was changed to human isophane insulin plus neutral insulin(70%/30%;Mixtard 30 HM;26 units/4 units).Linagliptin at 5 mg was added 1 month *** hemoglobin A 1c level declined to 8.1%1 year ***:PD-L1 inhibitors can induce type 1 diabetes,and patients can present with diabetic *** glucose levels should be regularly monitored in patients who are prescribed these medications.

关键词： atezolizumab diabetic ketoacidosis PD-L1 inhibitors Type 1 diabetes

atezolizumab致小细胞肺癌患者SOX1抗体阳性副肿瘤性脑炎并相关神经系统不良事件文献分析

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中国新药杂志 2023年第12期32卷 1269-1274页

作者：李潇张艳华北京大学肿瘤医院暨北京市肿瘤防治研究所药剂科/恶性肿瘤发病机制及转化研究教育部重点实验室北京100142

目的:探讨atezolizumab致中枢神经系统不良事件的临床特征及治疗策略,为临床识别及治疗提供参考。方法:检索Pubmed,Webscience,CNKI,Wanfang datebase等中英文数据库,筛选atezolizumab导致中枢神经系统不良事件的非综述性文章,并对相关... 详细信息

目的:探讨atezolizumab致中枢神经系统不良事件的临床特征及治疗策略,为临床识别及治疗提供参考。方法:检索Pubmed,Webscience,CNKI,Wanfang datebase等中英文数据库,筛选atezolizumab导致中枢神经系统不良事件的非综述性文章,并对相关病例总结分析,结合文献对我院收治的atezolizumab致小细胞肺癌患者SOX1抗体阳性副肿瘤性脑炎病例进行讨论。结果:atezolizumab致中枢神经系统不良反应案例已有报道,但以SOX1抗体阳性为特征的副肿瘤性脑炎为首例。自身抗体检测对本例临床诊断具有参考价值,及时的大剂量激素冲击疗法和血浆置换使本例患者得到较好的临床结局。结论:atezolizumab治疗前及治疗期间应密切监测患者的神经系统表现,警惕副肿瘤性脑炎的发生,必要时应对相关自身抗体进行系统性评估。

关键词： atezolizumab 神经免疫相关不良反应 SOX1抗体副肿瘤性脑炎