Efficacy and safety of atezolizumab/bevacizumab in patients with HCC after prior systemic therapy: A global, observational study

Year: 2023

Type: article

Abstract: BACKGROUND: Since the introduction of the combination treatment of anti-programmed death-ligand 1 antibody atezolizumab and anti-VEGF antibody bevacizumab (AB), median overall survival in HCC has drastically improved. However, evidence on the efficacy and safety of the novel treatment standard in patients with prior exposure to systemic treatment is scarce. The aim of this global, multicenter, observational study was to evaluate the efficacy and safety of AB in patients after previous systemic therapy. METHODS: We screened our global, multicenter, prospectively maintained registry database for patients who received any systemic therapy before AB. The primary end point was overall survival; secondary end points were time-to-progression, progression-free survival, objective response rate, and safety (rate and severity of adverse events). RESULTS: Among 493 patients who received AB for unresectable HCC, 61 patients received prior systemic therapy and were included in this analysis. The median age of the study population was 66 years, with 91.8% males. Predominant risk factors for HCC were viral hepatitis (59%) and alcohol (23%). Overall survival for AB was 16.2 (95% CI, 14.5-17.9) months, time-to-progression and progression-free survival were 4.1 (95% CI, 1.5-6.6) and 3.1 (95% CI, 1.1-5.1) months, respectively. The objective response rate was 38.2% (7.3% with complete and 30.9% with partial response). Overall survival was not influenced by treatment line (2nd vs. >2nd) or previous systemic treatment modality (tyrosine kinase inhibitors vs. immune checkpoint inhibitors). Treatment-related adverse events of all grades according to Common Terminology Criteria for Adverse Events were documented in 42.6% of patients, with only 13.1% of grade ≥3, including one death. CONCLUSION: In this observational study, AB emerges as a safe and efficacious treatment option in patients with HCC previously treated with other systemic therapy.

Source: Hepatology Communications

DOI: 10.1097/hc9.0000000000000302

Institutions: University Medical Center Hamburg-Eppendorf, Imperial College London, Medical University of Vienna, Campus Bio Medico University Hospital, The University of Texas MD Anderson Cancer Center, The University of Texas Health Science Center at Houston, Baylor College of Medicine, East Carolina University, The University of Texas Southwestern Medical Center, CHA University Bundang Medical Center, CHA University, Taipei Veterans General Hospital, Medical University of Graz, Mount Sinai Hospital, Tisch Cancer Institute, University of Pittsburgh, UPMC Health System, University of Pittsburgh Medical Center, National Yang Ming Chiao Tung University, University of Freiburg, University Medical Center Freiburg, Deutsches Konsortium für Translationale Krebsforschung, Humanitas University, IRCCS Humanitas Research Hospital, Johannes Gutenberg University Mainz, University Medical Center of the Johannes Gutenberg University Mainz, Università degli Studi del Piemonte Orientale “Amedeo Avogadro”

Language: English

Topic: Hepatocellular Carcinoma Treatment and Prognosis

Subfield: Hepatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,700

Awards: G1611021288, G2036276671, G4091157750, iSTAR - Förderung von Advanced Clinician Scientist im Bereich Entzündungs- und Infektionskrankheiten, G9000023190, G9000159372, G9000298081

OpenAlex ID: W4387965246