Abstract 709P
Background
Atezolizumab plus bevacizumab (atezo+bev) is standard of care first-line treatment in eligible patients with advanced HCC, but clear guidance on follow-up treatment is lacking. In IMbrave150, 36% of patients received systemic treatment after atezo+bev. Real-world evidence is needed to describe treatment patterns in clinical practice. This study describes the real-world use of atezo+bev and subsequent systemic treatments in patients with HCC in the United States (US).
Methods
Patients with HCC aged ≥18 years who initiated atezo+bev between June 2020 and November 2021 were identified in the IQVIA US Open Source Medical (Dx) and Pharmacy (LRx) databases. Eligible patients had data available for ≥3 months before and ≥2 months after atezo+bev initiation (index date), no prior systemic treatment for HCC, and no other prior primary cancers. Patients were followed from the index date to the end of Months 3, 6, 9, and 12. Endpoints assessed among patients with at least 3, 6, 9, and 12 months of follow-up included the proportion of patients discontinuing atezo+bev or switching to other systemic treatments, time to atezo+bev discontinuation (TTD), and time to next treatment (TTNT).
Results
Overall, 531 patients were included (mean age 66 years, 81% male). Most patients had compensated liver disease (ascites, 13%; hepatic encephalopathy, 4%). Only 17% had esophageal varices, and 2% had prior gastrointestinal hemorrhage. Nearly one-quarter (22%) had distant metastases. At 3, 6, 9, and 12 months, respectively, the proportion of patients who discontinued atezo+bev was 16% (of 531 patients at risk), 58% (of 461 patients), 77% (of 369 patients), and 88% (of 279 patients), the mean TTD was 21 days, 58 days, 81 days, and 102 days, the proportion of patients switching to other systemic treatments was 5%, 11%, 17%, and 20%, and the mean TTNT was 63 days, 107 days, 140 days, and 156 days.
Conclusions
Real-world treatment patterns demonstrated that over half of patients discontinued atezo+bev within 6 months, with a minority transitioning to other systemic treatments.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Bayer IQVIA.
Funding
Bayer.
Disclosure
A.G. Singal: Financial Interests, Personal, Advisory Role: Bayer, Eisai, Genentech, AstraZeneca, Exelixis, BMS, Glycotest, Exact Sciences, FujiFilm Medical Sciences, GRAIL; Financial Interests, Institutional, Research Grant: Exact Sciences, Glycotest. K. Ozgurdal: Financial Interests, Personal, Full or part-time Employment: Bayer. X. Fan: Financial Interests, Personal, Full or part-time Employment: Bayer. Z. Vassilev: Financial Interests, Personal, Full or part-time Employment: Bayer. C. Chen: Financial Interests, Personal, Full or part-time Employment: IQVIA; Financial Interests, Institutional, Research Grant: IQVIA. J.K. Multani: Financial Interests, Personal, Full or part-time Employment: IQVIA. Z. Zhou: Financial Interests, Personal, Full or part-time Employment: IQVIA; Financial Interests, Institutional, Research Grant: IQVIA. J. He: Financial Interests, Personal, Full or part-time Employment: IQVIA; Financial Interests, Institutional, Research Grant: IQVIA. F. Pisa: Financial Interests, Personal, Full or part-time Employment: Bayer.