170P - Atezolizumab plus bevacizumab (A+B) versus lenvatinib for BCLC-B stage of patients with hepatocellular carcinoma (HCC): A large real-life worldwide population

Background

The aim of the present study was to perform a real-world analysis on a large sample of patients with intermediate BCLC-B patients with HCC treated with A+B vs Lenvatinib.

Methods

The study population included patients enrolled affected by intermediate (BCLC-B) HCC patients not suitable for locoregional therapies from eastern and western populations, who received A+B or Lenvatinib as first-line treatment. Univariate and multivariate analyses were used to evaluate predictor factors for overall survivor (OS) and progression free survivor (PFS) while prognostic factors were analyzed by univariate and multivariate analysis using Cox regression model.

Results

919 BCLC-B HCC patients were enrolled in the study: 561 (61%) received Lenvatinib and 358 (39%) received A+B. The mOS for patients receiving Lenvatinib was 21,3 months compared to 15,8 months for patients receiving A+B as first-line treatment (Lenvatinib Vs A+B): HR 0,84 p =0,22. The mPFS for patients receiving Lenvatinib was 7,34 months compared to 8,68 months for patients receiving A+B as first-line treatment (Lenvatinib vs A+B): HR 1,15 p = 0,10. The multivariate analysis confirmed no different in terms of mOS and mPFS between the two treatments. Objective response rate (ORR) was 47,11 % for patients receiving Lenvatinib and 27 % for patients receiving A+B p < 0, 000001. Patients receiving Lenvatinib experienced a significantly higher incidence of hand-foot skin reaction (HFSR), hypertension, diarrhea, fatigue, decrease appetite, hypothyroidism, and other toxicity compared to patients receiving A+B. Favorable prognostic factors for OS in Lenvatinib group was platelets >100, HR 0,68 p= 0,02. No favorable prognostic factors were found for A+B group. Favorable prognostic factors for pfs in the A+B group were in those who performed at least one TACE previously HR 0.76 p=0.02, platelets <100 HR 0.62 p=0.0067, and nlr <3 HR 0.78 p=0.04.

Conclusions

Although Lenvatinib had a greater response, the study showed no statistically significant differences between Lenvatinib and A+B in terms of efficacy, in these two cohorts of BCLC-B HCC patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.