Abstract 955P
Background
Atezolizumab plus bevacizumab (Ate/Bev) has demonstrated the efficacy and safety in patients with advanced HCC (aHCC) as first-line treatment in the IMbrave 150 trial. Further evaluation in real-world setting is necessary to define prognostic factors with Ate/Bev treatment.
Methods
This is a multicenter, retrospective analysis performed by Korean Cancer Study Group (KCSG). Between May 2020 and February 2021, a total of 138 patients received Ate/Bev as first line treatment for aHCC from 11 Korean referral cancer institutions. We excluded patients with Child B/C class and Barcelona Clinic Liver Cancer stage (BCLC) D stage aHCC, and the remaining 121 patients who had at least one follow-up visit after the start of Ate/Bev were included in this analysis.
Results
Patients characteristics were as follows: median age of 61 years (range, 36-83); hepatitis B (n=93, 76.9%), hepatitis C (n=6, 5.0%), non-viral (n=22, 18.2%); BCLC B/C (n=25, 20.7%/n=96, 79.3%); macrovascular invasion (n=45, 37.2%); extrahepatic metastasis (n=85, 70.2%); and AFP ≥ 400 ng/ml (n=46, 38.0%). According to the RECIST 1.1, 2 patients achieved complete response (CR) and 27 patients achieved a partial response (PR), resulting in an overall response rate of 24.0% and disease control rate of 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 was not reached (95% CI, not available). Multivariate Cox analysis identified that baseline AFP<400 ng/ml (vs AFP≥400, hazard ratio [HR] 0.44, 95% CI 0.25-0.76, p=0.003) and AFP decrease ≥ 50% at first evaluation (vs <50% decrease or increase, HR 0.29, 95% CI, 0.09-0.99, p=0.048), baseline neutrophil-lymphocyte ratio (NLR) <5 (vs ≥5, HR 0.44, 95% CI 0.22-0.87, p=0.018) and best response of CR or PR (vs stable disease or progressive disease, HR 0.38, 95% CI, 0.14-0.99, p=0.049) were independent predictors of better PFS.
Conclusions
Ate/Bev showed real-life efficacy and safety outcomes for Korean aHCC patients in line with the results of a pivotal phase III trial. Baseline AFP, NLR, AFP response and tumor response (CR or PR) were associated with better PFS.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
J. Cheon: Financial Interests, Personal, Advisory Board: F. Hoffmann-La Roche; Bayer; Eisai; MSD; Financial Interests, Personal, Research Grant: Dong-A Pharmaceutical; F. Hoffmann-La Roche. C. Yoo: Financial Interests, Personal, Research Grant: Servier; Bayer; AstraZeneca; Ono Pharmaceuticals; Ipsen; Celgene; HK inno.N; Financial Interests, Personal, Advisory Board: Servier; Ipsen; AstraZeneca; Bayer; Financial Interests, Personal, Stocks/Shares: OncoCross; Financial Interests, Personal, Speaker’s Bureau: Servier; Bayer; AstraZeneca; Ipsen; Merk Serono; Celgene; MSD; HK inno.N; Debio Pharm; Kyowa Kirin; Boryung Pharmaceuticals; Janssen. H.J. Chon: Financial Interests, Personal, Advisory Board: F. Hoffmann-La Roche; Bayer; Eisai; Financial Interests, Personal, Research Grant: Dong-A Pharmaceuticals; F. Hoffmann-La Roche. H.Y. Lim: Financial Interests, Personal, Advisory Board: F. Hoffmann-La Roche. All other authors have declared no conflicts of interest.