Curative Locoregional Therapy following Objective Response to Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction: Atezolizumab plus bevacizumab (Atezo-Bev) is a standard first-line systemic therapy for unresectable hepatocellular carcinoma (HCC). We aimed to explore the benefits of adding curative locoregional therapy (LRT) to patients who achieve a partial response (PR) to Atezo-Bev treatment. Methods: This multinational retrospective study enrolled patients who received Atezo-Bev as first-line systemic therapy for unresectable HCC and reached complete response (CR) or PR. Patients were categorized into three cohorts: patients who underwent curative LRT after PR, patients with PR but did not receive curative LRT, and patients achieving CR without LRT. Curative LRT included surgery, ablation, and definitive radiotherapy with imaging evidence showing disease-free status afterward. Results: A total of 243 patients were enrolled from 8 countries or regions; 31 patients received curative LRT after PR, 180 patients obtained PR but did not receive curative LRT, and 32 patients achieved CR without LRT. The curative-LRT group, compared with patients who did not receive curative LRT after PR, exhibited significantly longer PFS (median, 44.4 months vs. 18.2 months, p = 0.004) and overall survival (OS) (median, not reached vs. 34.3 months, p < 0.001). The differences remained significant after inverse probability of treatment weighting (IPTW) adjustment. By contrast, whether before or after IPTW adjustment, the curative-LRT group did not exhibit statistically significant difference in PFS, OS, and recurrence-free survival from patients who obtained CR without curative LRT. Conclusion: Curative LRT may consolidate the efficacy of Atezo-Bev in patients achieving a PR, potentially prolonging survival compared to systemic therapy alone.
Source: Liver Cancer
DOI: 10.1159/lic/admag004
Authors: Yu-Yun Shao, San-Chi Chen, Kun-Ming Rau, Teng-Yu Lee, Stephen L. Chan, Ken Liu, Hsueh-Chou Lai, Jacob George, Cameron Gofton, Siraphong Putraveephong, Yin-Hsun Feng, Ming-Yang Lee, Jie XinJoycelyn Lee, David Tai, Suat Ying Lee, Yen-Hao Chen, Tsung-Che Wu, Lein-Ray Mo, Wan Zamaniah WI, Cosmas Rinaldi A. Lesmana, Cheng Vai Hui, Shu Sen Sam Li, Irsan Hasan, Landon L. Chan, Melinda Nguyen, Madhawa De Silva, Chien-Huai Chuang
Institutions: National Taiwan University, National Taiwan University Hospital, National Yang Ming Chiao Tung University, Taipei Veterans General Hospital, E-Da Hospital, Taichung Veterans General Hospital, Chung Shan Medical University, Chinese University of Hong Kong, Prince of Wales Hospital, Royal Prince Alfred Hospital, China Medical University Hospital, The University of Sydney, Westmead Hospital, Westmead Institute for Medical Research, Royal North Shore Hospital, Khon Kaen University, Chi Mei Medical Center, Chia-Yi Christian Hospital, National Cancer Centre Singapore, Kaohsiung Chang Gung Memorial Hospital, Tainan Municipal Hospital, Tainan Hospital, University of Malaya, University of Indonesia, Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, Hospital Conde S. Januário
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,590
OpenAlex ID: W7220688343