阿替妥珠单抗联合贝伐单抗（AB）的组合疗法是不可切除肝细胞癌（u-HCC）的一线治疗方案。免疫相关不良事件（irAEs）的处理是与接受AB疗法的患者获得良好疗效相关的重要问题。然而，目前对接受AB疗法的患者irAEs的发展研究还很少。本研究重点关注接受AB疗法的患者基线时自身抗体发展和irAEs发展之间的关联。纳入了61名接受AB疗法的患者。对于自身抗体，我们在开始AB疗法前测试了以下抗体：抗核抗体，类风湿因子（RF），抗甲状腺球蛋白抗体，甲状腺过氧化物酶抗体，抗甲状腺刺激素受体抗体和乙酰胆碱受体抗体。如果患者在基线时存在上述任何抗体中的任何一种，我们认为患者具有任何现有抗体。观察期间，有10名患者（16%）发生了irAEs。irAEs包括肝损伤、甲状腺功能减退、肾上腺功能不全、促肾上腺皮质激素释放激素缺乏症和横纹肌溶解症。与无irAE的患者相比，irAE发生的患者（n = 10）更有可能在基线时对任何自身抗体呈阳性（风险比（HR）：3.7，p = 0.047）和对RF呈阳性（HR：5.4，p = 0.035），并达到完全缓解（HR：5.8，p = 0.027）。基线时的自身抗体存在是与irAE发展相关的独立因素。实际情况中，16%的接受AB疗法治疗u-HCC的患者发生了irAEs。基线时存在自身抗体的患者患上irAEs的风险较高，需要谨慎的后续随访。本文受版权保护。保留所有权利。

Atezolizumab plus bevacizumab (AB) combination therapy is the first-line treatment for unresectable hepatocellular carcinoma (u-HCC). The management of immune-related adverse events (irAEs) is an important issue associated with achieving a good therapeutic response in patients receiving AB therapy. However, few studies have reported irAE development in patients receiving AB therapy. This study focused on the the association between irAE development and autoantibodies at baseline in patients receiving AB therapy.Sixty-one patients receiving AB therapy were enrolled. For autoantibodies, the following antibodies were tested before the start of AB therapy: antinuclear antibodies, rheumatoid factor (RF), anti-thyroglobulin antibodies, thyroid peroxidase antibodies, anti-thyroid stimulating hormone receptor antibodies, and acetylcholine receptor antibodies. A patient was considered to have any preexisting antibodies if any of the listed antibodies were present at baseline.Ten patients (16%) developed irAEs during the observation period. The irAEs included liver injury, hypothyroidism, adrenal insufficiency, adrenocorticotropic hormone deficiency, and rhabdomyolysis. Patients with irAE (n = 10) were more likely to be positive for any autoantibody (hazard ratio (HR): 3.7, p = 0.047) and RF at baseline (HR: 5.4, p = 0.035) and to achieve complete response (HR: 5.8, p = 0.027) than those without. The presence of autoantibodies at baseline was an independent factor associated with irAE development.In the real world, 16% of patients receiving AB therapy for u-HCC developed irAEs. Patients with autoantibodies at baseline are at high risk of developing irAEs and require cautious follow-up. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.