First-line atezolizumab/bevacizumab or durvalumab/tremelimumab in advanced hepatocellular carcinoma: a real world, multicenter retrospective study

作者：Ioannis Kournoutas, Paulina S. Marell, Jennifer Gile, Anina Peersen, Priyanshi Shah, Kyle VanDommelen, Suneel D. Kamath, Garima Gupta, Mehmet Akce, Ju Dong Yang, Pin‐Jung Chen, Nikolas Naleid, Amit Mahipal, Nicole Peterson, Vaibhav Sahai, Wen Wee, Zhaohui Jin, Thorvardur Halfdanarson, Lionel Fonkoua Kankeu, Leslie Washburn, Caitlin B. Conboy, Michael Torbenson, Ajit H. Goenka, Scott A. Thompson, Sudhakar K. Venkatesh, Patrick Starlinger, Lewis R. Roberts, Gregory J. Gores, Hani M. Babiker, Daniel H. Ahn, Mitesh J. Borad, Tanios Bekaii‐Saab, Aminah Jatoi, Robert R. McWilliams, Fang‐Shu Ou, Nguyen H Tran · 发表于：The Oncologist · 年份：2025 · DOI：10.1093/oncolo/oyaf286 · 被引用次数：6 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cancer Immunotherapy and Biomarkers、Cancer Mechanisms and Therapy

BACKGROUND: Unresectable hepatocellular carcinoma (uHCC) is a leading cause of cancer death. FDA-approved first-line systemic therapies include atezolizumab/bevacizumab (atezo/bev) and durvalumab/tremelimumab (durva/treme); however, there is a lack of comparative data. METHODS: We reviewed outcomes of patients with uHCC who initiated atezo/bev or durva/treme between 2017 and 2024, across six institutions. Overall survival (OS) and time to treatment discontinuation (TTD) were analyzed using the Kaplan-Meier and Cox models, adjusting for baseline characteristics. RESULTS: Four hundred fifty-two uHCC pts were included. Median age: 68 years; 77% male; 81% white. Most common etiologies were viral hepatitis (38.9%) and metabolic dysfunction-associated steatohepatitis (19.5%). Disease progression was the primary reason for treatment discontinuation, atezo/bev (56%) and durva/treme (42%). Outcomes were not statistically significant (median OS [month, m]: 14.0 vs 14.6 [P = .66]; median TTD [m]: 4.9 vs 3.9 [P = .42] for atezo/bev vs durva/treme). Outcomes were significantly different between Child-Pugh classes (CP: A, B7, B8/9, C) respectively, median OS(m): 19.0, 6.1, 5.1, 2.0 (P < .001); median TTD(m): 6.1, 2.3, 3.0, 1.3 (P < .001). CONCLUSIONS: In this real-world study of uHCC, no significant difference in clinical outcomes was observed between atezo/bev and durva/treme in the first-line setting. CP scores were a key prognostic variable with both regimens.