Efficacy and safety of atezolizumab plus bevacizumab in Korean patients with advanced hepatocellular carcinoma

Background & Aims Atezolizumab plus bevacizumab (Ate/Bev) has demonstrated efficacy and safety in patients with advanced hepatocellular carcinoma (HCC) in the phase III trial. Further evaluation is necessary to investigate the safety and efficacy of Ate/Bev in real settings. Methods This was a m...

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Published in:Liver international 2022-03, Vol.42 (3), p.674-681
Main Authors: Cheon, Jaekyung, Yoo, Changhoon, Hong, Jung Yong, Kim, Han Sang, Lee, Dae‐Won, Lee, Myung Ah, Kim, Jin Won, Kim, Ilhwan, Oh, Sang‐Bo, Hwang, Jun‐Eul, Chon, Hong Jae, Lim, Ho Yeong
Format: Article
Language:English
Subjects:
Antibodies, Monoclonal, Humanized
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Aspartate aminotransferase
atezolizumab
Bevacizumab
Bevacizumab - adverse effects
Carcinoma, Hepatocellular
Confidence intervals
Disease control
Hepatocellular carcinoma
Humans
Leukocytes (neutrophilic)
Liver cancer
Liver Neoplasms
Lymphocytes
neutrophil‐to‐lymphocyte ratio
Patients
Republic of Korea
Retrospective Studies
Safety
Survival
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Summary:Background & Aims Atezolizumab plus bevacizumab (Ate/Bev) has demonstrated efficacy and safety in patients with advanced hepatocellular carcinoma (HCC) in the phase III trial. Further evaluation is necessary to investigate the safety and efficacy of Ate/Bev in real settings. Methods This was a multicentre retrospective analysis. Between May 2020 and February 2021, 138 patients received Ate/Bev as first‐line treatment for advanced HCC from 11 institutions. We excluded patients with Child‐Pugh B or C and BCLC D stage, and the remaining 121 patients were included in this analysis. Results According to RECIST 1.1, the objective response and disease control rates were 24.0% and 76.0%. The median follow‐up duration was 5.9 months (95% confidence interval [CI], 5.4‐6.4), the median progression‐free survival (PFS) was 6.5 months (95% CI, 4.1‐9.0), and median overall survival (OS) was not reached (95% CI, not available). The most frequent grade 3‐4 adverse event was aspartate aminotransferase elevation (10.7%). In the multivariate analyses, AFP increase (P = .037), baseline neutrophil‐to‐lymphocyte ratio (NLR) ≥ 5 (P = .023), and best response to stable disease or progressive disease (P = .019) were significantly associated with worse PFS. Macrovascular invasion (P = .048) and baseline NLR ≥5 (P 
ISSN:1478-3223
1478-3231
DOI:10.1111/liv.15102