Initial therapeutic results of atezolizumab plus bevacizumab for unresectable advanced hepatocellular carcinoma and the importance of hepatic functional reserve

Cancer Med. 2023 Feb;12(3):2646-2657. doi: 10.1002/cam4.5145. Epub 2022 Aug 14.

Abstract

Aim: We analyzed the association between the modified albumin-bilirubin (mALBI) grade and therapeutic efficacy of atezolizumab plus bevacizumab (Atezo+Bev) for the treatment of unresectable hepatocellular carcinoma (u-HCC).

Methods: In this retrospective observational study, we included 71 u-HCC patients treated with Atezo+Bev between September 2020 and September 2021. Patients were grouped corresponding to the mALBI grade at the start of treatment (mALBI 1+2a or mALBI 2b+3) and analyzed for therapeutic effect and the transition rate to secondary treatment.

Results: According to the Response Evaluation Criteria in Solid Tumors, the overall response rate was significantly higher for the mALBI 1+2a group, than for the mALBI 2b+3 group, with 26.2% and 3.4%, respectively. The progression-free survival (PFS) was significantly longer in the mALBI 1+2a group (10.5 months) than in the mALBI 2b+3 group (3.0 months). In the multivariate analysis, an mALBI of 1+2a was found to be an independent factor of PFS. The rate of second-line treatment with multi-targeted agents was also significantly higher in the mALBI 1+2a group.

Conclusions: In real-world practice, Atezo+Bev treatment might have higher therapeutic efficacy in u-HCC patients with mALBI 1+2a.

Keywords: atezolizumab; bevacizumab; hepatocellular carcinoma.

Publication types

  • Observational Study

MeSH terms

  • Albumins
  • Bevacizumab
  • Bilirubin
  • Carcinoma, Hepatocellular*
  • Humans
  • Liver Neoplasms*

Substances

  • Bevacizumab
  • atezolizumab
  • Albumins
  • Bilirubin