Universität zu Köln

Sinner, Friedrich ORCID: 0000-0003-0524-8833, Pinter, Matthias ORCID: 0000-0002-7260-532X, Scheiner, Bernhard ORCID: 0000-0002-4904-5133, Ettrich, Thomas Jens, Sturm, Niklas ORCID: 0000-0001-9219-0099, Gonzalez-Carmona, Maria A., Waidmann, Oliver, Finkelmeier, Fabian ORCID: 0000-0001-8559-9910, Himmelsbach, Vera, De Toni, Enrico N., Ben Khaled, Najib, Mohr, Raphael ORCID: 0000-0003-2403-4275, Fruendt, Thorben Wilhelm, Kuetting, Fabian, van Boemmel, Florian, Lieb, Sabine, Krug, Sebastian ORCID: 0000-0003-1672-7995, Bettinger, Dominik ORCID: 0000-0002-8782-8729, Schultheiss, Michael, Jochheim, Leonie S., Best, Jan, Mueller, Christian ORCID: 0000-0002-6881-1817, Keitel, Verena and Venerito, Marino ORCID: 0000-0001-8581-0974 (2022). Atezolizumab Plus Bevacizumab in Patients with Advanced and Progressing Hepatocellular Carcinoma: Retrospective Multicenter Experience. Cancers, 14 (23). BASEL: MDPI. ISSN 2072-6694

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Abstract

Simple Summary Hepatocellular cancer is the most common type of primary liver cancer. It is the third leading cause of cancer-related deaths worldwide and its incidence is increasing: >1 million new cases per year expected by 2025. Despite advances in treatment in recent years, diagnosis is associated with poor overall survival. Treatment of hepatocellular cancer depends on the patient's general health and fitness, how well the liver is working, the number and size of tumors in the liver, and whether or not the tumor has spread to other neighboring or distant parts of the body. The combination of atezolizumab plus bevacizumab, two intravenously administered antibodies, is the preferred first-line treatment for patients with advanced hepatocellular cancer that has spread from the liver to other neighboring or distant parts of the body. This study investigated how long patients whose hepatocellular cancer continues to grow (progress) despite one or more prior tumor therapies live when they receive atezolizumab plus bevacizumab. These patients, treated with atezolizumab plus bevacizumab at various hospitals in Germany and Austria, lived about 16 months, which is about 5-8 months longer than patients receiving approved drugs. The safety profile was consistent with previous reports. Atezolizumab plus bevacizumab is the standard of care for first-line systemic therapy for advanced hepatocellular carcinoma (aHCC). Data on the efficacy and safety of atezolizumab plus bevacizumab in patients with aHCC who have received prior systemic therapy are not available. Methods: Patients with aHCC who received atezolizumab plus bevacizumab after at least one systemic treatment between December 2018 and March 2022 were retrospectively identified in 13 centers in Germany and Austria. Patient characteristics, tumor response rates, progression-free survival (PFS), overall survival (OS), and adverse events (AE) were analyzed. Results: A total of 50 patients were identified; 41 (82%) were male. The median age at initiation of treatment with atezolizumab plus bevacizumab was 65 years, 41 (82%) patients had cirrhosis, 30 (73%) Child A, 9 (22%) B, and 2 (5%) C. A total of 34 patients (68%) received atezolizumab plus bevacizumab in the second-line setting and 16 (32%) in later lines. The best radiologic tumor responses were complete remission (2%), partial remission (30%), stable disease (36%), and progressive disease (18%), resulting in an objective response rate of 32% and a disease control rate of 68%. Median OS was 16.0 months (95% confidence interval 5.6-26.4 months), and median PFS was 7.1 months (95% confidence interval 4.4-9.8 months). AE grades 3-4 were observed in seven (14%) and resulted in death in three patients (6%). There were five (10%) bleeding events with a grade >= 3, including one (2%) with a fatal outcome. Conclusions: Atezolizumab plus bevacizumab is effective in patients with aHCC who did not have access to this option as first-line therapy. The safety profile was consistent with previous reports.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sinner, Friedrich UNSPECIFIED orcid.org/0000-0003-0524-8833 UNSPECIFIED Pinter, Matthias UNSPECIFIED orcid.org/0000-0002-7260-532X UNSPECIFIED Scheiner, Bernhard UNSPECIFIED orcid.org/0000-0002-4904-5133 UNSPECIFIED Ettrich, Thomas Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Sturm, Niklas UNSPECIFIED orcid.org/0000-0001-9219-0099 UNSPECIFIED Gonzalez-Carmona, Maria A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Waidmann, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Finkelmeier, Fabian UNSPECIFIED orcid.org/0000-0001-8559-9910 UNSPECIFIED Himmelsbach, Vera UNSPECIFIED UNSPECIFIED UNSPECIFIED De Toni, Enrico N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ben Khaled, Najib UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohr, Raphael UNSPECIFIED orcid.org/0000-0003-2403-4275 UNSPECIFIED Fruendt, Thorben Wilhelm UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuetting, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED van Boemmel, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Lieb, Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Krug, Sebastian UNSPECIFIED orcid.org/0000-0003-1672-7995 UNSPECIFIED Bettinger, Dominik UNSPECIFIED orcid.org/0000-0002-8782-8729 UNSPECIFIED Schultheiss, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Jochheim, Leonie S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Best, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Christian UNSPECIFIED orcid.org/0000-0002-6881-1817 UNSPECIFIED Keitel, Verena UNSPECIFIED UNSPECIFIED UNSPECIFIED Venerito, Marino UNSPECIFIED orcid.org/0000-0001-8581-0974 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-696272
DOI:	10.3390/cancers14235966
Journal or Publication Title:	Cancers
Volume:	14
Number:	23
Date:	2022
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2072-6694
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SORAFENIB; CABOZANTINIB Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69627