Atezolizumab plus bevacizumab beyond first-line in hepatocellular carcinoma

Introduction Atezolizumab plus bevacizumab (atezo/bev) is the standard of care in first-line systemic therapy for advanced stage hepatocellular carcinoma (aHCC). Data on efficacy and safety of atezo/bev in patients with aHCC who received previous systemic therapy are not available.

Methods Patients with aHCC who received atezo/bev after at least one systemic treatment between December 2018 and March 2022 were retrospectively identified across 13 centers in Germany and Austria. Patient characteristics, tumor response rates, pro-gression-free survival (PFS), overall survival (OS) and adverse events (AE) were analyzed.

Results Overall, 50 patients were identified, 41 (82%) were male. The median age at the start of atezolizumab plus bevacizumab was 65 years, 41 (82%) patients had liver cirrhosis, 30 (73%) Child A, 9 (22%) B and 2 (5%) C. Overall, 34 patients (68%) received atezolizumab plus bevacizumab in second-line and 16 (32%) in later lines. Best radiological tumor responses were complete remission (2%), partial remission (30%), stable disease (36%) and progressive disease (18%), resulting in an objective response rate of 32% and a disease control rate of 68%. Median OS was 16.0 months (95% CI 5.6-26.4 months), and mPFS was 7.1 months (95% CI 4.4-9.8 months). AE grade 3-4 were observed in 7 (14%) and led to death in 3 patients (6%). There were 5 (10%) bleeding events of grade≥3, one of them (2%) with fatal outcome.

Conclusion Atezo/bev is effective beyond first-line in aHCC. The safety profile was consistent with previous reports.

Publication History

Article published online:
18 January 2023