Organ‐specific responses to atezolizumab plus bevacizumab in advanced hepatocellular carcinoma: A multicentre, retrospective study

Background and Aims Anti‐programmed death 1 (PD‐1) monotherapy triggers various responses by each organ. In advanced hepatocellular carcinoma (HCC), while extrahepatic lesions demonstrate objective response rates (ORR) of 20%–40%, only 10% of intrahepatic lesions respond. Although first‐line atezoli...

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Published in:Liver international 2024-08, Vol.44 (8), p.1961-1970
Main Authors: Cheon, Jaekyung, Jung, Sanghoon, Kim, Jung Sun, Kang, Beodeul, Kim, Hyeyoung, Chan, Landon L., Becker, Lars, Gaillard, Vincent E., Chan, Stephen L., Kim, Chan, Chon, Hong Jae
Format: Article
Language:English
Subjects:
atezolizumab
Bevacizumab
Hepatitis B
Hepatocellular carcinoma
Lesions
Liver cancer
Lymph nodes
Metastases
Microenvironments
Observational studies
organ‐specific response
response
Survival
Tumors
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Summary:Background and Aims Anti‐programmed death 1 (PD‐1) monotherapy triggers various responses by each organ. In advanced hepatocellular carcinoma (HCC), while extrahepatic lesions demonstrate objective response rates (ORR) of 20%–40%, only 10% of intrahepatic lesions respond. Although first‐line atezolizumab/bevacizumab has shown survival benefits in advanced HCC, organ‐specific responses remain unexplored. Therefore, we aimed to assess organ‐specific responses in patients with advanced HCC receiving atezolizumab/bevacizumab. Methods This retrospective, multicenter, observational study included patients who received first‐line atezolizumab/bevacizumab for advanced HCC. Patients with Child‐Pugh class A, measurable tumour lesions and serial imaging available for response evaluation were eligible. Results Between May 2020 and June 2021, 131 patients (median age: 62) from three cancer referral institutions were included. Ninety‐one had hepatitis B (69.5%), 108 were at Barcelona clinic liver cancer stage C (82.4%), and 78 had extrahepatic metastasis (59.5%). After a median follow‐up of 10.1 months, median progression‐free survival was 6.8 months (95% confidence interval [CI], 4.6–9.2), median overall survival remained unreached (95% CI, range unavailable) and the ORR was 29.0%. Among 270 individual tumour lesions, the liver was the most commonly involved organ (n = 158). Atezolizumab/bevacizumab induced ORR of 27.8%, 42.2%, 29.1% and 21.0% for liver, lymph nodes, lungs and other sites, respectively. The organ‐specific response rate for intrahepatic tumours decreased with increasing size (35.6%:
ISSN:1478-3223
1478-3231
1478-3231
DOI:10.1111/liv.15935