Initial Experience of Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma in Real-World Clinical Practice

Abstract

Background: Atezolizumab plus bevacizumab was approved for patients with hepatocellular carcinoma (HCC). Although clinical trials have revealed its efficacy, the outcomes in the real-world clinical practice are unclear. We retrospectively evaluated the efficacy and safety of atezolizumab plus bevacizumab for HCC. Materials and Methods: This is a multicenter study conducted between November 2020 and March 2021. Among the 61 patients, 51 were assessed for progression-free survival (PFS), therapeutic response, and adverse events (AEs). Results: The median PFS was 5.4 months. The objective response rate (ORR) was 35.3%. The disease control rate (DCR) was 86.3%. The incidence rates of AEs at any grade and grade >3 were 98.0% and 29.4%, respectively. The most frequent AE at any grade and grade >3 was hepatic disorder. In patients with a previous history of molecular targeted agent (MTA) or the degree of albumin-bilirubin (ALBI) grade, there were no significant differences in the PFS, ORR, DCR, and incidence rates of AEs. Conclusion: The study demonstrated that atezolizumab plus bevacizumab was effective and safe for patients with HCC even in the real-world setting including patients with a previous MTA history or other than ALBI grade 1.

Early Tumor Response and Safety of Atezolizumab Plus Bevacizumab for Patients with Unresectable Hepatocellular Carcinoma in Real-World Practice

“…On the other hand, some reports on the initial experience of Atezo + Bev in real-world practice have already been reported. According to these reports, the efficacy was similar in patients who were initiated as first-line treatment and in patients who had a history of prior systemic treatment [14][15][16]. However, in our study, the ORR decreased slightly in the second-line or later treatment group, so this finding also needs further investigation.…”

The Prognostic Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Hepatocellular Carcinoma Receiving Atezolizumab Plus Bevacizumab

“…Recently, Iwamoto et al reported the first real-world outcomes of atezolizumab plus bevacizumab treatment in 60 patients with HCC in Japan [ 36 ]. In our study, there were 27 patients who received atezolizumab plus bevacizumab as first-line treatment with a PR of 29.6% and DCR of 66.6%; these data were similar to the results of the IMbrave150 study.…”

“…Nevertheless, information on atezolizumab plus bevacizumab in real-world practice is relatively limited. Recently, Iwamoto reported the first real-world outcomes of atezolizumab plus bevacizumab treatment in patients with uHCC in Japan [ 36 ]. However, to the best of our knowledge, information regarding the clinical impact of NLR in patients with uHCC receiving atezolizumab plus bevacizumab is unclear.…”

Evaluating the Role of Hepatobiliary Phase of Gadoxetic Acid-Enhanced Magnetic Resonance Imaging in Predicting Treatment Impact of Lenvatinib and Atezolizumab plus Bevacizumab on Unresectable Hepatocellular Carcinoma

“…The third main finding of our study was that assessment by the EOB-MRI hepatobiliary phase affected PFS in the atezolizumab plus bevacizumab group (Figures 1 and 2). We also examined liver function and the neutrophil-to-lymphocyte ratio (NLR) that have been reported to be associated with PFS for atezolizumab plus bevacizumab therapy, but found no statistical differences [20,21]. One of the reasons for predicting therapeutic effects is that the heterogeneous and hyperintense types were present in a certain number of patients with HCC carrying β-catenin mutation.…”