970P - Comparing clinical outcomes between PD-1 and PD-L1 inhibitors plus bevacizumab combined with hepatic arterial interventional therapies in unresectable hepatocellular carcinoma: A single-center, real-world study

Background

Systemic therapies combined with locoregional therapies were considered a potent therapeutic strategy in treating patients with unresectable hepatocellular carcinoma (uHCC). Given the bevacizumab plus atezolizumab strategy recommended as the first-line treatment for advanced HCC patients, the roles of programmed cell death protein 1 (PD-1) and programmed cell death-ligand 1 (PD-L1) inhibitors in the combination therapies for treating patients with uHCC needed to be further discussed. The current study compared the clinical outcomes between PD-1 and PD-L1 inhibitors plus bevacizumab combined with hepatic arterial interventional therapies (HAIT) among patients with uHCC.

Methods

From October 2019 to May 2023, 142 uHCC patients who received HAIT combined with systemic therapies were retrospectively analyzed in Sun Yat-sen University Cancer Center, including 74 or 68 patients treated with either PD-1 (PD-1 group) or PD-L1 (PD-L1 group) inhibitors combined with HAIT plus bevacizumab. The progression-free survival (PFS) and tumor responses were analyzed per RECIST criteria.

Results

At the data cut-off, the median PFS was 5.5 months in the PD-1 group and 7.5 months in the PD-L1 group, respectively (P=0.280). The PD-L1 group showed a significantly better median intrahepatic PFS (8.1 months, 95%CI 7.6-10.2 months) than the PD-1 group (6.5 months, 95%CI 6.2-9.0 months; P=0.014). Moreover, the PD-L1 group demonstrated a significantly higher intrahepatic response rate (60.2% vs. 35.1%, P=0.005) than the PD-1 group according to RECIST criteria. The treatment-related adverse events were similar between the two groups.

Conclusions

PD-1 or PD-L1 plus bevacizumab combined with HAIT shared similar overall PFS in treating uHCC patients. However, the PD-L1 plus bevacizumab combined with HAIT demonstrated better intrahepatic PFS and intrahepatic control rate than those of PD-1, which needed further validation at a higher evidence level.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Y. Pan.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.