Abstract 235P
Background
The recent early detection initiatives in Egypt revealed a considerable rise in the incidence and prevalence of hepatocellular carcinoma (HCC). Hepatitis C virus (HCV) infection is one of the contributing factors and is considered a major health problem in Egypt. The management of HCC exerts an economic burden on the healthcare system. The approved treatment agents for advanced HCC, either with immunotherapy or tyrosine kinase inhibitors or monoclonal antibodies, remain relatively expensive in most developing countries. In this study, we aimed to evaluate the therapeutic outcomes of these approved treatments for Egyptian patients with advanced HCC.
Methods
A Retrospective chart review was conducted between July 2021 and December 2023. We included patients who were newly diagnosed with HCC, either radiologically or by tissue biopsy, and had a history of HCV infection. Patients were classified into two groups:1) those who received first line Atezolizumab/Bevacizumab and 2) those who received first line Sorafenib.
Results
A total of 84 patients were identified; 82% were male and the median age was 63.5 years. There were 46 patients (54.7%) in group 1 (Atezo/Beva); and 38 patients(45.3%) in group 2 (Sorafenib). The objective response rate was significantly higher in the Atezo/Beva group (68.3% vs.31.7%, p value = 0.015). Similarily, the median progression-free survival and the overall survival were higher in the Atezo/Beva group (4.9 vs. 2.9 months, and 9.9 vs. 8.0 months respectively), however, not statistically significant. Further subgroup analysis revealed that the Child Pugh score, previous local treatment, Alpha Feto Protein level, and portal vein invasion did not have a significant impact on the survival outcomes between the two treatment groups.
Conclusions
This is the first study to compare the effectiveness of Atezo/Beva and Sorafenib in Egyptian patients with advanced HCC. Combined Atezolizumab/Bevacizumab was superior to Sorafenib in the objective response rate, median progression free survival and overall survival. Larger sample sizes and longer follow-up are needed to validate the results and to identify the ideal candidates for each treatment line.
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.