Tharwat M, Tawheed A, El-Kassas M. Atezolizumab and bevacizumab combination in advanced hepatocellular carcinoma patients: The imperative for safety assessment studies. World J Clin Cases 2025; 13(9): 99043 [DOI: 10.12998/wjcc.v13.i9.99043]
Corresponding Author of This Article
Mohamed El-Kassas, MD, Professor, Department of Endemic Medicine, Faculty of Medicine, Helwan University, Ain Helwan, Cairo 11795, Egypt. m_elkassas@hq.helwan.edu.eg
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 26, 2025; 13(9): 99043 Published online Mar 26, 2025. doi: 10.12998/wjcc.v13.i9.99043
Atezolizumab and bevacizumab combination in advanced hepatocellular carcinoma patients: The imperative for safety assessment studies
Mina Tharwat, Ahmed Tawheed, Mohamed El-Kassas
Mina Tharwat, Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Aswan University, Aswan 81528, Egypt
Ahmed Tawheed, Mohamed El-Kassas, Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11795, Egypt
Author contributions: Tharwat M and Tawheed A wrote the manuscript and revised the manuscript; El-Kassas M designed the overall concept and outline of the manuscript; and all authors contributed to this article and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohamed El-Kassas, MD, Professor, Department of Endemic Medicine, Faculty of Medicine, Helwan University, Ain Helwan, Cairo 11795, Egypt. m_elkassas@hq.helwan.edu.eg
Received: July 11, 2024 Revised: November 18, 2024 Accepted: December 2, 2024 Published online: March 26, 2025 Processing time: 153 Days and 10.1 Hours
Abstract
Hepatocellular carcinoma (HCC) is the most prevalent cancer of the hepatobiliary tract and the third leading cause of cancer-related mortality worldwide. Atezolizumab and bevacizumab combination is currently considered among the front-line treatment modalities for advanced unresectable HCC. Most studies examining this combination were focused on evaluating its effectiveness. Despite numerous case reports documenting some side effects, there is a limited number of large-scale studies assessing these side effects. In 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.
Core Tip: In this article, we comment on the case report by Park et al, published in the recently reporting a fatal intra-tumoral hemorrhage in a patient with hepatocellular carcinoma following successful treatment with atezolizumab/bevacizumab. Multiple predictive factors have been reported to be associated with such condition. They can be categorized as either patient-related (age, systemic hypertension, and use of anticoagulants), liver disease-related (degree of liver decompensation and thrombocytopenia), or tumor-related (portal vein thrombosis). However, future studies are required to assess the long-term safety of this combination in patients with hepatocellular carcinoma.
