Atezolizumab Plus Bevacizumab in Patients with Unresectable Hepatocellular Carcinoma: Real-World Experience From a US Community Oncology Network

Abstract

Purpose: Atezolizumab plus bevacizumab (atezo-bev) is a preferred first-line (1L) systemic therapy option for unresectable hepatocellular carcinoma (uHCC). However, evidence of its effectiveness in real-world clinical practice, including in patients with impaired liver function, remains limited. Patients and Methods: This retrospective observational study included adult patients who initiated 1L atezo-bev for uHCC within The US Oncology Network between 1/1/2019 and 8/31/2022 using structured and unstructured electronic health records data. Overall survival (OS) and real-world progression-free survival (rwPFS) were assessed using Kaplan-Meier methods for the overall cohort and in a subgroup of “trial-like” patients with characteristics that were consistent with those of the IMbrave150 Trial (ECOG performance status 0–1, Child-Pugh class A, albumin-bilirubin grade 1–2). Results: Overall, 374 patients met eligibility criteria (mean age 68.8 years, 78.9% male, 31% Child-Pugh class B-C among reported, 18% ECOG performance status ≥2 among reported), of whom 132 patients comprised the trial-like subgroup. At a median follow-up of 5.6 months, median (95% CI) OS was 13.2 (9.5, 15.9) months and rwPFS was 6.4 (5.1, 7.7) months. In the trial-like subgroup, median (95% CI) OS was 16.5 (13.2, NR) months and rwPFS was 9.4 (5.7, 12.5) months. Conclusion: Atezo-bev was used as 1L systemic therapy for HCC in a diverse patient population across US community oncology settings. Real-world effectiveness of atezo-bev among trial-like patients is comparable to that reported in the Phase 3 study. These data can help guide selection of appropriate treatment candidates and maximize the benefits of atezo-bev in routine clinical practice.