While patients with unresectable hepatocellular carcinoma (HCC) have historically received first-line treatment with sorafenib, results from the IMbrave150 suggest that the combination of the PD-L1 inhibitor atezolizumab with the angiogenesis inhibitor bevacizumab may be a more effective treatment option. Initial results from this randomized, phase III trial (N = 501) showed a significant overall survival (OS) advantage for patients receiving atezolizumab plus bevacizumab compared to sorafenib (not reached vs 13.2 months; HR 0.58, P = .006), as well as improvements in progression-free survival (PFS) and comparable rates of adverse events (AEs). At the Gastrointestinal Cancers Symposium 2020, Peter Galle, MD, PhD (University Medical Center, Mainz, Germany), presented updated results from this trial, including quality-of-life analysis.
Atezolizumab plus bevacizumab was associated with significant improvement in median time to deterioration of patient-reported quality-of-life compared to sorafenib. The median time to deterioration was 11.2 months with the atezolizumab/bevacizumab combination and 3.6 months with sorafenib (HR 0.63). Similar improvements were seen in time to deterioration of physical functioning (13.1 months vs 4.9 months; HR 0.53) and role functioning (9.1 months vs 3.6 months; HR 0.62). Fewer patients in the atezolizumab/bevacizumab arm experienced reductions in quality-of-life related to symptoms such appetite loss, fatigue, pain, and diarrhea.
Dr Galle concluded that in addition to prolonging survival, the combination of atezolizumab and bevacizumab improves quality-of-life compared to sorafenib in patients with advanced, unresectable HCC, and should be considered as a new frontline treatment option for HCC.
Read more about this study on Medscape Medical News.