Abstract 210P
Background
The aim of the present study is to perform a real-world analysis on a large sample of patients with Barcelona Clinic Liver Cancer stage B (BCLC-B) hepatocellular carcinoma (HCC) treated with Atezolizumab plus Bevacizumab (A+B) vs Lenvatinib.
Methods
The study population included patients enrolled affected by intermediate (BCLC-B) HCC patients not suitable for locoregional therapies (LRTs) 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 Time to progression (TTP) while prognostic factors were analyzed by univariate and multivariate analysis using Cox regression model.
Results
919 patients were enrolled: 561 (61%) received Lenvatinib and 358 (39%) received A+B. The median overall survivor (mOS) for Lenvatinib cohort was 21.3 months compared to 15.8 months for A+B cohort as first-line treatment (Lenvatinib Vs A+B): Hazard ratio (HRs) 0.84 p=0.22. The median time to progression (mTTP) for Lenvatinib cohort was 7.3 months compared to 8.7 months for A+B cohort 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 mTTP between the two treatments. Objective response rate (ORR) was 47.1% for Lenvatinib cohort and 27.1% for A+B cohort p & lt; 0.000001. Lenvatinib cohort showed a significantly higher incidence of hand-foot skin reaction (HFSR), hypertension, diarrhea, fatigue, decrease appetite, hypothyroidism compared to A+B cohort. Favorable prognostic factors for OS in Lenvatinib cohort were, platelets (PLT) > 100.000 (HR 0.68 p= 0.02), HCC non-alcoholic steatohepatitis/non-alcoholic fatty liver disease (NASH/NAFLD) related (HR 0.53, p=0.03). Favorable prognostic factors for TTP in the A+B cohort were in TACE refractory patients (HR 0.76, p=0.02), PLT <100.000 (HR 0.62, p=0.0067), and Neutrophil-to-lymphocyte ratio (NLR) <3 (HR 0.78, p=0.04).
Conclusions
The study showed a greater response of Lenvatinib and no statistically significant differences between Lenvatinib and A+B in terms of efficacy.
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.