Which factors predict mortality in Atezo/Bev-treated advanced HCC?

A study has found the high bilirubin, pretreatment hypoalbuminemia, and biochemical tests indicative of hepatic or renal dysfunctions are independently associated with short-term mortality in patients with advanced hepatocellular cancer (HCC) receiving atezolizumab and bevacizumab (Atezo/Bev).

Patients aged ≥18 years treated for advanced primary liver cancer between February 2020 and August 2022 were included in this retrospective review. The research team examined the association between overall survival and clinical and biochemical variables before or during treatment. They performed univariate and multivariate Cox regression analyses to identify predictors of survival after treatment.

Overall, 111 patients with unresectable HCC met the eligibility criteria and received Atezo/Bev over a consecutive 30-month period.

In univariate analysis, the following factors significant predicted survival (p<0.05): pretreatment albumin (hazard ratio [HR], 0.2, 95 percent confidence interval [CI], 0.1‒0.4), total bilirubin (HR, 1.3, 95 percent CI, 1.2‒1.5), and international normalized ratio (HR, 5.6, 95 percent CI, 2.5‒12.5).

Multivariate analyses confirmed the significance of the above factors in predicting mortality in patients with advanced HCC. In addition, those with pretreatment albumin <3.5 mg/dL were found to have shorter survival than patients with pretreatment albumin ≥3.5 mg/dL (153 vs 522 days; p<0.0001).

“In randomized clinical trials in patients with HCC, combination therapy with Atezo/Bev prolonged survival, and these treatments have become the standard first-line therapy for advanced HCC,” the researchers said.