Alimentary Pharmacology & Therapeutics, Journal Year: 2025, Volume and Issue: unknown
Published: Feb. 17, 2025
We appreciate the interest of Salimi and Liu in our study on variceal bleeding (VB) risk patients receiving atezolizumab–bevacizumab (Atezo–Bev) for hepatocellular carcinoma (HCC) their insightful comments highlighting importance stratification [1, 2]. fully concur that VB factors should not be overlooked a patient-specific approach is crucial clinical decision-making. One key finding from we would like to emphasise 14 45 (31%) who experienced had no varices observed pretreatment oesophagogastroduodenoscopy (OGD) [2]. Of note, 12 these (85.7%) portal vein invasion (PVI), with seven cases (50%) involving extensive main PVI. Our multivariable analysis also identified PVI as strong predictor risk. This suggests even classified low based standard OGD criteria may still face substantial due tumour-related factors, particularly Therefore, traditional solely findings inadequate this population, necessitating more comprehensive assessment incorporating tumour burden vascular involvement. Another important point higher incidence (22% vs. 3%) received prophylaxis compared those did not. As noted by Liu, interpreted caution. Rather than suggesting lack efficacy prophylaxis, likely reflects selection bias, where were inherently at baseline. discussed paper, significant including history gastrointestinal bleeding, advanced liver cirrhosis. Thus, difference does necessarily indicate failure but rather highlights need improved timely intervention highest patients. In addition, initially sought develop prediction model findings. However, relatively limited number events external validation, constructing statistically robust proved challenging. believe future efforts larger sample size multicentre cohorts will essential establishing model. A validated could significantly enhance decision-making, allowing precise personalised strategies undergoing Atezo–Bev treatment. Given consensus guidelines prevention during treatment [3], hope contributes development evidence-based strategies. Based findings, such platelet count, PVI, needing undergo vigilant monitoring VB. Jonggi Choi: conceptualization, funding acquisition, writing – original draft, review editing, project administration. article linked Park et al papers. To view articles, visit https://doi.org/10.1111/apt.18526 https://doi.org/10.1111/apt.70017. Data sharing applicable new data created or analyzed study.
Language: Английский