Home > Gastroenterology > DDW 2024 > Liver and Biliary Tract Diseases Updates > Superior OS with atezolizumab plus bevacizumab versus lenvatinib in unresectable HCC

Superior OS with atezolizumab plus bevacizumab versus lenvatinib in unresectable HCC

Presented by
Dr Sangdao Boonkaya, King Chulalongkorn Memorial Hospital, Thailand
Conference
DDW 2024
Doi
https://doi.org/10.55788/25a99f0b
Atezolizumab plus bevacizumab demonstrated superior overall survival (OS) as a first-line systemic treatment compared with lenvatinib for unresectable hepatocellular carcinoma (HCC). Additionally, potential predictors of response to lenvatinib or atezolizumab/bevacizumab therapy were assessed.

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 1.07–3.84; P=0.03), with no significant difference in median PFS compared with lenvatinib (7.1 vs 5.4 months; HR 1.38; 95% CI 0.62–3.05; 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.

“In 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,” summarised Dr Boonkaya.


    1. 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, 18–21 May, Washington, DC, USA.

Copyright ©2024 Medicom Medical Publishers



Posted on