985P - Characteristics and outcomes in patients (pts) with unresectable hepatocellular carcinoma (uHCC) who initiated second-line (2L) therapy after receiving first-line (1L) atezolizumab plus bevacizumab (atezo+bev) and in those who did not

Background

Atezo+bev is a standard of care 1L treatment for uHCC. Currently, there is no evidence to guide treatment decision-making after discontinuation of 1L atezo+bev. Therefore, we aimed to describe the real-world characteristics and outcomes in pts with uHCC who initiated 2L therapy after receiving 1L atezo+bev vs those who did not.

Methods

Oncologists from a US nationally representative network extracted electronic medical chart data for pts with uHCC who received 1L atezo+bev between June 1, 2020 and March 6, 2023. Pts were stratified into two groups based on whether they started 2L therapy within 8 weeks of 1L atezo+bev discontinuation. Pt demographic and clinical characteristics, duration of 1L treatment (DOT), and overall survival (OS) were assessed.

Results

We identified 484 eligible pts (median age, 66 years; 64.9% male; 62.6% White). At baseline, most had good performance status (ECOG PS 0–1, 79.5%) and liver function (Child-Pugh [CP]-A, 81.4%). A higher proportion of pts in the 2L (n=141) vs no 2L (n=40) cohort were White (69.5% vs 52.5%), non-Hispanic (78.0% vs 60.0%), and had Medicare/Medicaid insurance (72.3% vs 45.0%). Between 1L and 2L initiation, liver function deteriorated (CP-A, 74.5% to 52.5%) as did performance status (ECOG PS ≥2: 8.5% to 45.3%). Pts who did not initiate 2L therapy had worse performance status (ECOG PS ≥2, 52.5% vs 8.5%) and liver dysfunction (CP-B or C, 40.0% vs 25.5%). Although median 1L DOT was similar between the 2L and no 2L cohorts (6.9 vs 7.8 months), median OS from 1L initiation was nearly twice as long among 2L (26.0 months [95% CI 21.3, 27.2]) vs no 2L (14.3 months [95% CI 10.2, 24.8]) cohort pts.

Conclusions

This study provides real-world data for sequential therapy in uHCC following atezo+bev. The findings showed differences between pts initiating 2L therapy and those who did not, highlighting the need for better pt selection at the start of 1L atezo+bev and the potential benefit of timely switching from 1L atezo+bev to subsequent therapies.

Clinical trial identification

Editorial acknowledgement

Editorial assistance in the preparation of this abstract was provided by OPEN Health Scientific Communications, London, UK, with financial support from Bayer.

Legal entity responsible for the study

The authors.

Funding

Bayer.

Disclosure

A. Singal: Financial Interests, Personal, Speaker, Consultant, Advisor: Bayer, Eisai, Genentech, BMS, Exelixis, AstraZeneca, Wako Diagnostics, Exact Sciences, Roche, Glycotest, GRAIL, TARGET PharmaSolutions. K. Ozgurdal, Z. Vassilev, F. Pisa, X. Pan: Financial Interests, Personal, Full or part-time Employment: Bayer. All other authors have declared no conflicts of interest.