ASCO-GI 2020 – Unresectable HCC: atezolizumab plus bevacizumab tops sorafenib in patient-reported outcomes


  • Pavankumar Kamat
  • Univadis
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Takeaway

  • Patients with unresectable hepatocellular carcinoma (HCC) could maintain a better quality of life with atezolizumab plus bevacizumab compared with sorafenib.  

Why this matters

  • The IMbrave150 trial has already shown that first-line treatment with atezolizumab plus bevacizumab has a survival benefit over sorafenib in patients with unresectable HCC.
  • In palliative settings where life-expectancy is limited, it is important to consider the patient perspective on the overall clinical benefit to maintain the quality of the remaining lifespan.

Study design

  • Patient-reported quality of life analysis of the phase 3 IMbrave150 trial.
  • IMbrave150: patients with unresectable HCC previously untreated with systemic therapy (n=501) were randomly assigned (2:1) to either atezolizumab plus bevacizumab or sorafenib.
  • Time to deterioration (TTD) was defined as a 10-point reduction in key patient-reported outcomes from the baseline.
  • Funding: F. Hoffmann-La Roche, Ltd.

Key results

  • Compared with sorafenib, atezolizumab plus bevacizumab delayed TTD of patient reported quality of life (median TTD, 11.2 vs 3.6 months; HR, 0.63 [95% CI, 0.46-0.85]), physical functioning (median TTD, 13.1 vs 4.9 months; HR, 0.53 [95% CI, 0.39-0.73]), and role functioning (median TTD, 9.1 vs 3.6 months; HR, 0.62 [95% CI, 0.46-0.84]).
  • Fewer patients receiving atezolizumab plus bevacizumab showed clinically meaningful deterioration in specific symptoms, including appetite loss, fatigue, pain, and diarrhea compared with sorafenib.

Limitations

  • IMbrave150 trial had an open-label design.

Expert commentary

Dr Craig Lockhart, MD, from the University of Miami Sylvester Comprehensive Cancer Center, Florida commented: “The expense will be something that we will have to consider but we will weigh that in the context of the patient reported data that we just saw.”