https://doi.org/10.55788/25a99f0b
Dr Sangdao Boonkaya (King Chulalongkorn Memorial Hospital, Thailand) presented retrospectively collected data from 130 patients with unresectable HCC who received lenvatinib (n=52) or atezolizumab/bevacizumab (n=78) as first-line therapies between 2020 and 2023 [1]. Atezolizumab and bevacizumab are monoclonal antibodies that target the protein programmed cell death-ligand 1 and the vascular endothelial growth factor, respectively. The primary endpoints were median progression-free survival (PFS) and OS.
Treatment with atezolizumab/bevacizumab significantly improved OS (10.6 vs 7.0 months; HR 2.02; 95% CI 1.07â3.84; P=0.03), with no significant difference in median PFS compared with lenvatinib (7.1 vs 5.4 months; HR 1.38; 95% CI 0.62â3.05; P=0.43). The objective response rate was also similar between the 2 groups (23.1% vs 19.2%, P=0.60).
Multivariate analyses revealed that serum total bilirubin (P=0.01), sodium (P=0.01), and alpha-fetoprotein (P=0.03) levels were associated with OS. Adverse events, particularly diarrhoea and fatigue, were significantly more common in the lenvatinib group, whereas the atezolizumab/bevacizumab group exhibited higher rates of infection, gastrointestinal bleeding, and fatigue. Liver decompensation was found in 14.1% of patients treated with atezolizumab/bevacizumab and in 15.4% in the lenvatinib group.
âIn our study, first-line treatment with atezolizumab/bevacizumab showed superior OS outcomes compared with lenvatinib in patients with unresectable HCC. However, objective response rates and PFS did not significantly differ between both therapies. Atezolizumab/bevacizumab had higher rates of gastrointestinal bleeding, while lenvatinib showed higher rates of diarrhoea and fatigue,â summarised Dr Boonkaya.
- Boonkaya S, et al. Comparison efficacy and safety between atezolizumab plus bevacizumab and lenvatinib as first-line systemic therapy for hepatocellular carcinoma: a real-world study. 325, DDW 2024, 18â21 May, Washington, DC, USA.
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