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e-Poster Display Session

169P - IMbrave150: Management of adverse events of special interest (AESIs) for atezolizumab (atezo) and bevacizumab (bev) in unresectable HCC

Date

22 Nov 2020

Session

e-Poster Display Session

Topics

Tumour Site

Hepatobiliary Cancers

Presenters

Masatoshi Kudo

Citation

Annals of Oncology (2020) 31 (suppl_6): S1287-S1318. 10.1016/annonc/annonc356

Authors

M. Kudo1, M. Ikeda2, A. Zhu3, S. Qin4, T. Kim5, H.Y. Lim6, V. Breder7, P. Merle8, A. Kaseb9, D. Li10, N. Ma11, M. Villalobos12, S. Stanzel13, V.E. Gaillard14, D. Xu15, S. Hernandez11, A. Cheng16, R.S. Finn17, P.R. Galle18, M. Ducreux19

Author affiliations

  • 1 Department Of Gastroenterology And Hepatology, Kindai University Faculty of Medicine, 589-8511 - Osaka/JP
  • 2 Department Of Hepatobiliary & Pancreatic Oncology, National Cancer Center Hospital East, 277-8577 - Kashiwa/JP
  • 3 Department Of Medicine, Harvard Medical School, Massachusetts General Hospital Cancer Center, 02214 - Boston/US
  • 4 Cancer Center, People’s Liberation Army Cancer Center, 210002 - Nanjing/CN
  • 5 Medical Oncology Center, Seoul National University College of Medicine, Seoul/KR
  • 6 Oncology, Samsung Medical Center, Seoul/KR
  • 7 Chemotherapy, N.N. Blokhin Russian Cancer Research Center, Moscow/RU
  • 8 Hepatology Unit, University Hospital La Croix-Rousse, Lyon/FR
  • 9 Gi Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston/US
  • 10 Department Of Medical Oncology & Therapeutics Research, City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte/US
  • 11 Product Development Oncology, Genentech, Inc., South San Francisco/US
  • 12 Clinical Safety Science, Genentech, Inc., South San Francisco/US
  • 13 Biostatistics, F. Hoffmann-La Roche, Ltd, Basel/CH
  • 14 Product Development Medical Affairs, F. Hoffmann-La Roche, Ltd, Basel/CH
  • 15 Product Development Oncology, Roche Product Development, Shanghai/CN
  • 16 Department Of Medical Oncology, National Taiwan University Cancer Center and National Taiwan University Hospital, 10048 - Taipei/TW
  • 17 Department Of Medicine, Division Of Hematology And Oncology, Jonsson Comprehensive Cancer Center, Geffen School of Medicine at UCLA, 90095 - Los Angeles/US
  • 18 I. Dept. Of Internal Medicine, University Medical Center Mainz, Mainz/DE
  • 19 Department Of Medical Oncology, Gustave Roussy Cancer Center, Villejuif/FR

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Abstract 169P

Background

In the phase III IMbrave150 trial, atezo + bev demonstrated a statistically significant and clinically meaningful improvement in overall survival (OS) and progression-free survival (PFS) vs sorafenib (sor) in patients (pts) with unresectable HCC. Here we report on the AESIs for both atezo and bev in IMbrave150.

Methods

Eligible pts (N = 501) had unresectable HCC and were randomised 2:1 to receive atezo 1200 mg IV q3w + bev 15 mg/kg IV q3w or sor 400 mg PO bid until unacceptable toxicity or loss of clinical benefit per investigator. Co-primary endpoints were OS and PFS by independent review facility–assessed RECIST 1.1. AESIs were defined by the sponsor and reported without judgement of causality. AESIs for atezo were based on the immune-mediated risks of atezo and other checkpoint inhibitors; AESIs for bev were based on known adverse drug reactions (ADRs) with bev. Analyses explored the incidence, nature and severity of AESIs as well as corticosteroid use.

Results

The safety-evaluable population included 329 pts in the atezo + bev arm and 156 pts in the sor arm. Median follow-up was 8.6 mo (data cutoff: 29 Aug 2019); median tx durations were 7.4 (atezo), 6.9 (bev) and 2.8 (sor) mo. AESIs for atezo occurred in 69% of pts receiving atezo + bev and also in 82% of pts receiving sor (Table). 12% of pts in the atezo + bev arm vs 3% of pts in the sor arm experienced AESIs requiring systemic corticosteroid tx within 30 days of AE onset. AESIs for bev occurred in 58% of pts receiving atezo + bev and 49% of pts receiving sor. The reported events were ADRs well known with bev, and their frequency and severity were consistent with the safety profile of bev and the underlying disease.

Conclusions

In IMbrave150, AESIs for atezo and bev were manageable. Further, the nature and severity of AESIs were consistent with the known safety profiles of the individual agents and the underlying disease Table: 169P

AESIs, n (%)a Atezo + Bev n = 329 Sor n = 156
All G3-4 All G3-4
For atezo
Pts with ≥ 1 226 (69) 85 (26) 128 (82) 47 (30)
Hepatic eventsb 142 (43) 70 (21) 62 (40) 26 (17)
Inc AST 64 (20) 23 (7) 26 (17) 8 (5)
Inc blood bilirubin 43 (13) 8 (2) 22 (14) 10 (6)
Inc ALT 46 (14) 12 (4) 14 (9) 2 (1)
Ascites 23 (7) 6 (2) 9 (6) 2 (1)
Rash 64 (20) 2 (1) 96 (62) 21 (14)
Hypothyroidism 36 (11) 0 4 (3) 0
Infusion-related reactions 36 (11) 8 (2) 0 0
For bev
Pts with ≥ 1 190 (58) 76 (23) 76 (49) 29 (19)
Hypertension 102 (31) 50 (15) 40 (26) 19 (12)
Bleeding/haemorrhage 83 (25) 21 (6) 27 (17) 9 (6)
Epistaxis 34 (10) 0 7 (5) 1 (1)
Upper GI bleedingc 24 (7) 15 (5) 8 (5) 8 (5)
Proteinuria 70 (21) 10 (3) 13 (8) 1 (1)

Inc, increased. a In ≥ 5% of pts. b ≥ 1 category possible. c Grouped MedDRA PT

.

Clinical trial identification

NCT03434379.

Editorial acknowledgement

Medical writing assistance for this abstract was provided by Kia C. E. Walcott, PhD of Health Interactions, and funded by F. Hoffmann-La Roche, Ltd.

Legal entity responsible for the study

F. Hoffmann-La Roche, Ltd.

Funding

F. Hoffmann-La Roche, Ltd.

Disclosure

M. Kudo: Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution): Eisai; Honoraria (self): Bayer; Honoraria (self), Honoraria (institution): MSD; Honoraria (self), Honoraria (institution): BMS; Honoraria (self): Lilly; Honoraria (institution), Research grant/Funding (institution): EA Pharma; Research grant/Funding (institution): Gilead Sciences; Research grant/Funding (institution): Taiho; Research grant/Funding (institution): Sumitomo Dainippon Pharma; Research grant/Funding (institution): Takeda; Research grant/Funding (institution): Otsuka; Research grant/Funding (institution): AbbVie; Advisory/Consultancy: Ono; Advisory/Consultancy: Roche. M. Ikeda: Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution): Lilly; Honoraria (self): Taiho; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution): Chugai; Honoraria (self), Advisory/Consultancy: Novartis; Honoraria (self), Research grant/Funding (institution): Yakult; Honoraria (self): Teijin; Honoraria (self), Advisory/Consultancy: Servier; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution): Eisai; Honoraria (self), Research grant/Funding (institution): Bayer; Advisory/Consultancy, Research grant/Funding (institution): AstraZeneca; Research grant/Funding (institution): Ono; Research grant/Funding (institution): Bristol-Myers; Research grant/Funding (institution): MSD; Research grant/Funding (institution): J-Pharma; Research grant/Funding (institution): Aslan; Research grant/Funding (institution): Takeda; Research grant/Funding (institution): Merck Serono; Research grant/Funding (institution): Astellas. A.X. Zhu: Advisory/Consultancy: Lilly; Advisory/Consultancy: Bayer; Advisory/Consultancy: Roche; Advisory/Consultancy: Merck; Advisory/Consultancy: Sanofi; Advisory/Consultancy: Exelixis; Advisory/Consultancy: Eisai. H.Y. Lim: Advisory/Consultancy: Bayer; Advisory/Consultancy: Eisai; Advisory/Consultancy: BMS; Advisory/Consultancy: Ono; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Roche. V. Breder: Advisory/Consultancy, Travel/Accommodation/Expenses: Roche; Advisory/Consultancy, Travel/Accommodation/Expenses: MSD; Travel/Accommodation/Expenses: Bayer; Advisory/Consultancy, Travel/Accommodation/Expenses: Eisai; Advisory/Consultancy, Travel/Accommodation/Expenses: BMS; Advisory/Consultancy: Ipsen. P. Merle: Advisory/Consultancy, Ad Board: Bayer; Advisory/Consultancy, Ad Board: Eisai; Advisory/Consultancy, Ad Board: Exelixis; Advisory/Consultancy, Ad Board: Ipsen; Advisory/Consultancy, Ad Board: Lilly; Advisory/Consultancy, Ad Board: Roche; Advisory/Consultancy, Ad Board: AstraZeneca; Advisory/Consultancy, Ad Board: BMS; Advisory/Consultancy, Ad Board: MSD; Advisory/Consultancy, Ad Board: Merck; Advisory/Consultancy, Ad Board: Onxeo. A. Kaseb: Honoraria (self), Research grant/Funding (institution), Research Support: Genentech/Roche; Research grant/Funding (institution), Research Support: BMS; Research grant/Funding (institution), Research Support: Exelixis; Research grant/Funding (institution), Research Support: Bayer; Research grant/Funding (institution), Research Support: AdaptImmune; Research grant/Funding (institution), Research Support: Immatics; Research grant/Funding (institution), Research Support: Merck; Research grant/Funding (institution), Research Support: Eisai. D. Li: Advisory/Consultancy: Genentech. N. Ma: Shareholder/Stockholder/Stock options, Full/Part-time employment: Genentech/Roche. M. Villalobos: Full/Part-time employment: Genentech/Roche. S. Stanzel: Shareholder/Stockholder/Stock options, Full/Part-time employment: Roche. V.E. Gaillard: Travel/Accommodation/Expenses, Shareholder/Stockholder/Stock options, Full/Part-time employment: Roche. D-Z. Xu: Full/Part-time employment: Roche. S. Hernandez: Shareholder/Stockholder/Stock options, Full/Part-time employment: Genentech/Roche. A-L. Cheng: Honoraria (self), Advisory/Consultancy: AstraZeneca; Honoraria (self): Yakuhin; Honoraria (self), Advisory/Consultancy: Eisai; Honoraria (self), Advisory/Consultancy: Genentech/Roche; Honoraria (self): Lilly; Advisory/Consultancy: Bayer Schering Pharma; Advisory/Consultancy: BeiGene, Ltd; Advisory/Consultancy: Bristol-Myers Squibb; Advisory/Consultancy: CSR Pharma Group; Advisory/Consultancy: IQVIA; Advisory/Consultancy: MSD; Advisory/Consultancy: Novartis; Advisory/Consultancy: Ono Pharmaceutical. R.S. Finn: Advisory/Consultancy: AstraZeneca; Advisory/Consultancy, Research grant/Funding (institution): Bayer; Advisory/Consultancy, Research grant/Funding (institution): Bristol-Myers Squibb; Advisory/Consultancy, Research grant/Funding (institution): Eisai; Advisory/Consultancy: Exelixis; Advisory/Consultancy, Research grant/Funding (institution): Genentech/Roche; Advisory/Consultancy, Research grant/Funding (institution): Lilly; Advisory/Consultancy, Research grant/Funding (institution): Merck; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (institution): Novartis; Advisory/Consultancy, Research grant/Funding (institution): Pfizer. P.R. Galle: Honoraria (self): Bayer; Speaker Bureau/Expert testimony: BMS; Honoraria (self): AstraZeneca; Honoraria (self): Lilly; Honoraria (self): Sirtex; Honoraria (self): MSD; Honoraria (self): Ipsen; Honoraria (self): Roche; Advisory/Consultancy: SillaJen; Advisory/Consultancy: Eisai. M. Ducreux: Full/Part-time employment: Sandoz (I); Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Amgen; Honoraria (self), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Bayer; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Celgene; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Ipsen; Honoraria (self), Advisory/Consultancy: Lilly; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Merck Serono; Honoraria (self): MSD Oncology; Honoraria (self), Advisory/Consultancy: Novartis; Honoraria (self): Roche/Genentech; Honoraria (self), Advisory/Consultancy: Servier; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (institution), Travel/Accommodation/Expenses: Roche; Speaker Bureau/Expert testimony: Merck KGaA; Research grant/Funding (institution): Keocyt. All other authors have declared no conflicts of interest.

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