992P - Analyzing effectiveness and safety of standard-dose and low-dose bevacizumab combination with atezolizumab in patients with unresectable hepatocellular carcinoma: a multi-institutional study in Taiwan

Background

IMbrave150 trial confirmed the better clinical benefits with 1200 mg of atezolizumab plus 15 mg/kg of bevacizumab (Atezo/Bev) than with sorafenib for patients with unresectable hepatocellular carcinoma (HCC). However, effectiveness and safety with low-dose bevacizumab still remained uncertain in real-world practice. Our study aimed to investigate this issue.

Methods

We conducted a retrospective cohort study by using the Chang Gung Research Database, a multi-institutional electronic medical records database in Taiwan. The eligible patients were locally advanced metastatic and/or unresectable HCC with newly prescribed Atezo/Bev as first-line treatment between January 1, 2020 and December 31, 2022. The index date was the time Atezo/Bev initiation. We classified patients into: (1) the standard-dose group (15 mg/kg bevacizumab), and (2) the low-dose group (< 15 mg/kg bevacizumab). The primary outcome was overall survival (OS) and secondary outcomes included progression-free survival (PFS) and bleeding events. We applied Kaplan-Meier curve to estimate median OS and PFS. Moreover, we used Cox regression model to analyze hazard ratio (HR) and 95% confidence interval (CI) between two group.

Results

We enrolled total 151 patients in our analysis, with 15 patients newly receiving standard-dose bevacizumab (mean [SD] age: 58.5 [10.8]; male: 60.0%) and 136 patients receiving low-dose bevacizumab (mean [SD] age: 61.9 [11.6]; male: 77.9%). With a median 10.1 months of follow-up, the median OS was 14.9 months (95% CI: 1.4 to not reached [NR]) for standard-dose group and 11.2 months (95% CI: 8.8 to 14.3) for low-dose group (HR: 0.78, 95% CI: 0.38-1.56, P=0.48). Also, the median PFS (8.4 vs. 5.7 months, P=0.59) and the rate for bleeding events (20.0% vs. 25.0%, P=0.23) were similar in both groups.

Conclusions

Our study demonstrated no significant difference in OS, PFS and bleeding events between patients receiving standard-dose and low-dose bevacizumab in combination with atezolizumab in real-world clinical practice. Further large scale study was suggested to confirm our findings.

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.