Efficacy and Safety of Atezolizumab plus Bevacizumab versus Sorafenib in Hepatocellular Carcinoma with Main Trunk and/or Contralateral Portal Vein Invasion in IMbrave150

作者：Richard S. Finn, Peter R. Galle, Michel Ducreux, Ann‐Lii Cheng, Norelle R. Reilly, Alan Nicholas, Sairy Hernandez, Ning Ma, Philippe Merle, Riad Salem, Daneng Li, В. В. Бредер · 发表于：Liver Cancer · 年份：2024 · DOI：10.1159/000539897 · 被引用次数：35 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cholangiocarcinoma and Gallbladder Cancer Studies、Retinal Diseases and Treatments

Introduction: Atezolizumab plus bevacizumab significantly improved overall survival (OS) and progression-free survival (PFS) versus sorafenib in patients with unresectable hepatocellular carcinoma (HCC) in IMbrave150. Efficacy and safety in patient subpopulations with Vp4 portal vein tumor thrombosis (PVTT) and other high-risk prognostic factors are reported. Methods: IMbrave150 was a global, randomized (2:1), open-label, phase 3 study in systemic treatment–naive patients with unresectable HCC; OS and PFS were co-primary endpoints. Exploratory analyses compared the efficacy and safety of atezolizumab 1,200 mg plus bevacizumab 15 mg/kg every 3 weeks versus sorafenib 400 mg twice daily in patients (i) with and without Vp4 PVTT alone and (ii) with and without high-risk prognostic factors. Results: In patients with Vp4 PVTT, median OS was 7.6 months (95% CI: 6.0–13.9) with atezolizumab plus bevacizumab (n = 48) and 5.5 months (95% CI: 3.4–6.7) with sorafenib (n = 25; HR 0.62 [95% CI: 0.34–1.11]; descriptive p = 0.104). Median PFS in the respective arms was 5.4 months (95% CI: 3.6–6.9) and 2.8 months (95% CI: 1.5–5.3; HR 0.62 [95% CI: 0.35–1.09]; descriptive p = 0.094). In patients without Vp4, median OS was 21.1 months (95% CI: 18.0–24.6) with atezolizumab plus bevacizumab (n = 288) and 15.4 months (95% CI: 12.6–18.6) with sorafenib (n = 140; HR 0.67 [95% CI: 0.51–0.88]; descriptive p = 0.003). Median PFS in the respective arms was 7.1 months (95% CI: 6.1–9.6) and 4.7 months (95%...