Atezolizumab-bevacizumab combo trumps sorafenib for advanced HCC

The combination of atezolizumab and bevacizumab is better than sorafenib at maintaining clinically meaningful survival benefits over the long term in patients with unresectable hepatocellular carcinoma (HCC), reports a recent update to the IMbrave150 study.

“The primary analysis of IMbrave150 showed that atezolizumab plus bevacizumab had significantly greater benefits than sorafenib in patients with advanced hepatocellular carcinoma, but survival data were not yet mature,” said the researchers, who conducted a mortality analysis over a year later.

A total of 501 patients were included in the intention-to-treat analysis, of whom 336 received first-line atezolizumab plus bevacizumab, while 165 were given sorafenib. After a median follow-up of 15.6 months, the respective median overall survival (OS) durations were 19.2 months and 13.4 months.

Cox proportional hazards analysis confirmed that the OS advantage in patients receiving the combination treatment was statistically significant (hazard ratio [HR], 0.66, 95 percent confidence interval [CI], 0.52–0.85; p<0.001).

Similarly, median progression-free survival was significantly longer in the atezolizumab-bevacizumab arm (6.9 vs 4.3 months; HR, 0.65, 95 percent CI, 0.53–0.81; p<0.001).

In terms of safety, treatment-related grade 3/4 side effects occurred at comparable rates in the atezolizumab-bevacizumab vs sorafenib arms (43 percent vs 46 percent), as did grade 5 events (2 percent vs <1 percent).

According to the researchers, the updated results confirmed that the combination of atezolizumab and bevacizumab was both an effective and safe first-line option for patients with advanced HCC.