Benefit of adjuvant atezolizumab/bevacizumab in HCC not maintained over time

Previous results from the phase 3 IMbrave050 trial showed a significantly improved recurrence-free survival (RFS) of patients with HCC who underwent resection or ablation with curative intent with adjuvant atezolizumab/bevacizumab versus active surveillance. The updated results show that this result was not maintained over longer follow-up.

IMbrave050 (NCT04102098) randomised 668 participants with HCC 1:1 to 12 months (or 17 cycles) of adjuvant atezolizumab/bevacizumab or active surveillance; crossover was permitted [1]. At a median follow-up of 17.4 months, RFS was significantly improved compared with active surveillance (HR 0.72; adjusted 95% CI 0.53–0.98; P=0.012). This earlier observed RFS benefit was not maintained with longer follow-up (to a median of 35.1 months) [2].

The updated median RFS, presented by Dr Adam Yopp (UT Southwestern Medical Center, TX, USA), was 33.2 months in the atezolizumab/bevacizumab arm versus 36.0 months with active surveillance (HR 0.90; 95% CI 0.72–1.12; see Figure) [2]. RFS was consistent in all subgroups. Updated overall survival remained immature but showed a numerical improvement from the first interim analysis (from HR 1.42; P=0.229 to HR 1.26; P=0.250).

Figure: Updated median RFS in IMbrave050 [2]



Dr Yopp concluded that “this updated analysis does not support atezolizumab/bevacizumab as an adjuvant therapy for patients with high-risk HCC.”

1. Qin S, et al. Lancet 2023;402:1835-1847.
2. Yopp A, et al. Updated efficacy and safety data from IMbrave050: Phase III study of adjuvant atezolizumab (atezo) + bevacizumab (bev) vs active surveillance in patients (pts) with resected or ablated high-risk hepatocellular carcinoma (HCC). Abstract LBA39, ESMO Congress 2024, 13–17 September, Barcelona, Spain.

 

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Posted on 4 November 20244 November 2024