Atezolizumab and bevacizumab in patients with advanced hepatocellular carcinoma with impaired liver function and prior systemic therapy – a real-world experience

Aim Evaluation of efficacy and safety of atezolizumab+bevacizumab in real-world patients with impaired liver function and prior systemic therapy.

Methods 79 patients treated with atez/bev at two german university hospitals were retrospectively analyzed.

Results Almost half of the cohort (46.8%) met at least one major exclusion criteria of IMbrave150-trial (hereafter referred to as IMbrave-OUT, n=37), whereas 53.2% were eligible (IMbrave-IN, n=42). The overall response and disease control rates were 19.0% and 53.1%, respectively. Patients in IMbrave-IN group had longer median overall survival (not reached vs 4.4 months, 95% CI 1.05 – 7.58; p=0.008) and a trend for longer median progression-free survival (5.7, CI 95% 2.3 – 9.1, months vs 3.3, 95% CI 2.0 – 4.5, months; p=0.068) than the IMbrave-OUT group. Prior systemic treatment had no significant impact on OS (p=0.68). mOS was not yet reached for patients with ALBI grade 1 and 4.4 months for patients with ALBI grade 2/3 with no difference for ORR, DCR and mPFS. Absence of baseline ascites and portal vein invasion (PVI) were independent prognostic predictors [HR 0.37 (95% CI 0.17 – 0.77; p=0.008)] and [HR 0.46 (95%CI 0.23 – 0.93; p=0.030)], respectively. 39 patients (41.8%) had a CTCAE grade ≥3 and patients in the IMbrave-OUT group were at higher risk for hepatic encephalopathy (18.9% vs 0%, p=0.003) and ascites (32.4% vs. vs. 14.3%; p=0.01).

Conclusion Efficacy in this real-world cohort was comparable to the results of IMbrave150-trial, regardless of prior systemic therapy . Presence of PVI and ascites at baseline independently impacted survival.

Publikationsverlauf

Artikel online veröffentlicht:
26. Januar 2022