Clinical outcomes with atezolizumab plus bevacizumab or lenvatinib in patients with hepatocellular carcinoma: a multicenter real-world study.
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Persano Mara, Rimini Margherita, Tada Toshifumi, Suda Goki, Shimose Shigeo, Kudo Masatoshi, Cheon Jaekyung, Finkelmeier Fabian, Lim Ho Yeong, Rimassa Lorenza, Presa José, Masi Gianluca, Yoo Changhoon, Lonardi Sara, Tovoli Francesco, Kumada Takashi, Sakamoto Naoya, Iwamoto Hideki, Aoki Tomoko, Chon Hong Jae, Himmelsbach Vera, Pressiani Tiziana, Kawaguchi Takumi, Montes Margarida, Vivaldi Caterina, Soldà Caterina, Piscaglia Fabio, Hiraoka Atsushi, Sho Takuya, Niizeki Takashi, Nishida Naoshi, Steup Christoph, Iavarone Massimo, Di Costanzo Giovanni, Marra Fabio, Scartozzi Mario, Tamburini Emiliano, Cabibbo Giuseppe, Foschi Francesco Giuseppe, Silletta Marianna, Hirooka Masashi, Kariyama Kazuya, Tani Joji, Atsukawa Masanori, Takaguchi Koichi, Itobayashi Ei, Fukunishi Shinya, Tsuji Kunihiko, Ishikawa Toru, Tajiri Kazuto, Ochi Hironori, Yasuda Satoshi, Toyoda Hidenori, Ogawa Chikara, Nishimura Takashi, Hatanaka Takeshi, Kakizaki Satoru, Shimada Noritomo, Kawata Kazuhito, Tada Fujimasa, Ohama Hideko, Nouso Kazuhiro, Morishita Asahiro, Tsutsui Akemi, Nagano Takuya, Itokawa Norio, Okubo Tomomi, Arai Taeang, Imai Michitaka, Kosaka Hisashi, Naganuma Atsushi, Koizumi Yohei, Nakamura Shinichiro, Kaibori Masaki, Iijima Hiroko, Hiasa Yoichi, Cammarota Antonella, Burgio Valentina, Cascinu Stefano, Casadei-Gardini Andrea
Аннотация
METHODS: Overall cohort included Western and Eastern hepatocellular carcinoma (HCC) patient populations from 46 centres in 4 countries (Italy, Germany, Japan, and Republic of Korea).
RESULTS: 1312 patients were treated with lenvatinib, and 823 patients were treated with atezolizumab plus bevacizumab. Objective response rate (ORR) was 38.6% for patients receiving lenvatinib, and 27.3% for patients receiving atezolizumab plus bevacizumab (p < 0.01; odds ratio 0.60). For patients who achieved complete response (CR), overall survival (OS) was not reached in both arms, but the result from univariate Cox regression model showed 62% reduction of death risk for patients treated with atezolizumab plus bevacizumab (p = 0.05). In all multivariate analyses, treatment arm was not found to be an independent factor conditioning OS. Comparing ORR achieved in the two arms, there was a statistically significant difference in favor of lenvatinib compared to atezolizumab plus bevacizumab in all subgroups except for Eastern patients, Child-Pugh B patients, presence of portal vein thrombosis, α-feto-protein ≥ 400 ng/mL, presence of extrahepatic disease, albumin-bilirubin (ALBI) grade 2, and no previous locoregional procedures.
CONCLUSION: Lenvatinib achieves higher ORR in all patient subgroups. Patients who achieve CR with atezolizumab plus bevacizumab can achieve OS so far never recorded in HCC patients. This study did not highlight any factors that could identify patient subgroups capable of obtaining CR.