1005P - Atezolizumab plus bevacizumab combined with transarterial chemoembolization and hepatic arterial infusion chemotherapy for unresectable hepatocellular carcinoma with high tumor burden

Background

Despite the availability of effective systemic therapies such as atezolizumab plus bevacizumab (A+B), the response rate remains unsatisfactory for patients with unresectable hepatocellular carcinoma with high tumor burden (uHTB-HCC). Our previous studies indicated that transarterial chemoembolization (TACE) combined with FOLFOX-based hepatic arterial infusion chemotherapy (HAIC) showed favorable results for HCC. This study aims to evaluate the efficacy and safety of A+B combined with TACE-HAIC for uHTB-HCC.

Methods

This retrospective study included uHTB-HCC (meeting at least one of the following criteria: beyond up-to-11, VP 3-4, extrahepatic metastases) pts who received TACE-HAIC followed by atezolizumab (1200mg IV) and bevacizumab (15mg/kg IV q4w) between March 2022 and December 2022. Efficacy was evaluated based on tumor response and survival rates, while safety was assessed by adverse events (AEs).

Results

Thirty-five uHTB-HCC pts received A+B combined with TACE-HAIC. Based on mRECIST criteria, the objective response rate (ORR) was 68.6%, with 8 (22.9%) pts achieved complete response, 16 (45.7%) partial response, 4 (11.4%) stable disease, and 7 (20.0%) progression disease. Additionally, 5 (14.3%) pts underwent curative hepatectomy after being converted to resectable HCC. The 1-year overall survival and progression-free survival rates were 94.3% and 71.4%, respectively. Of the 32 (91.4%) pts who experienced treatment-related adverse events (AEs), 13 (37.1%) had grade 3-4 AEs, but no treatment-related deaths occurred.

Table: 1005P

Conclusions

The results suggested that A+B combined with TACE-HAIC was a promising treatment option for uHTB-HCC pts, given its excellent therapeutic efficacy and manageable adverse events.

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.