Abstract 185P
Background
The role of pts gender and disease etiology on 1L treatment outcome in uHCC is still debated. We investigated the putative prognostic effect of these factors on real-world uHCC overall survival (OS) and progression-free survival (PFS) on atezolizumab/bevacizumab (AB) or lenvatinib (L) 1L.
Methods
We conducted a retrospective multi-center, multi-National (Europe and Asiatic non-China), analysis of well-characterized uHCC pts receiving AB or L. Univariate analyses for OS and PFS were conducted after stratifying pts as viral males (VM), non-viral males (NVM), viral females (VF), and non-viral females (NVF) with the Kaplan-Meier method. Cox regression was used to adjust for patients’ subgroup imbalances.
Results
We included 1,759 male and 467 female pts. One hundred fifty-four (60%) male pts received L and 705 (40%) AB. VM were 56%. Significantly (p<0.05) different characteristics of NVM vs VM were higher age at diagnosis, less frequent prior locoregional therapies (LRT), higher Child Pugh score, and lower alfafetoprotein (AFP). Female pts received L in 287 cases (62%) and AB in 180 (38%). VF were 60%. Significantly (p<0.05) different characteristics of NVF vs VF included less frequent prior LRT and higher AFP. At a median follow-up of 12.7 months, no differences in terms of OS were found for gender with either L (HR 1.05, p 0.61) or the AB treatment (HR 1.17, p 0.30). In male pts, PFS was prolonged with AB compared to L (HR, 0.83 p 0.002). In VM, no statistical difference in terms of OS was identified between the two treatments, whilst AB improved PFS over L (HR 0.76, p 0.001). AB superiority in PFS was not confirmed in NVM. In female pts, no difference between the two treatments in terms of OS (HR 1.04, p 0.78) and PFS (HR 0.81, p 0.10) was identified. In VF, AB improved PFS compared to L (HR 0.72, p 0.049); in NVF no differences were observed. In the exploratory analysis of BCLC-B pts, L improved OS over AB only in NVF (p 0.030). After adjusting for differential clinical factors, the independent role in PFS for AB was confirmed only in VM (p=0.0002).
Conclusions
This analysis revealed no significant differences in OS for either AB or L when selecting pts by gender and etiology. In VM, AB is an independent factor of improved PFS.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.