Real-World Study of Systemic Treatment after First-Line Atezolizumab plus Bevacizumab for Hepatocellular Carcinoma in Asia-Pacific Countries
6
Issued Date
2024-01-01
Resource Type
ISSN
22351795
eISSN
16645553
Scopus ID
2-s2.0-85205362312
Journal Title
Liver Cancer
Rights Holder(s)
SCOPUS
Bibliographic Citation
Liver Cancer (2024)
Suggested Citation
Lee C.K., Yoo C., Hong J.Y., Park S.J., Kim J.W., Tai D.W.M., Kim H., Korphaisarn K., Tanasanvimon S., Chen S.C., Kim J.W., Kim I., Kim M., Choo J., Oh S.B., Chen C.T., Bae W.K., Kim H., Huh S.J., Yen C.J., Park S., Lee D.K., Chan L.L., Kang B., Kang M., Sundar R., Choi H.J., Chan S.L., Chon H.J., Lee M.A. Real-World Study of Systemic Treatment after First-Line Atezolizumab plus Bevacizumab for Hepatocellular Carcinoma in Asia-Pacific Countries. Liver Cancer (2024). doi:10.1159/000540969 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/101546
Title
Real-World Study of Systemic Treatment after First-Line Atezolizumab plus Bevacizumab for Hepatocellular Carcinoma in Asia-Pacific Countries
Author's Affiliation
The Catholic University of Korea Seoul St. Mary's Hospital
Korea University Anam Hospital
Pusan National University Hospital
Ulsan University Hospital
Siriraj Hospital
Yonsei Cancer Hospital
Chungbuk National University Hospital
Seoul National University Bundang Hospital
Inje University Paik Hospital
National Cheng Kung University Hospital
National Taiwan University Hospital
Asan Medical Center
National Cancer Centre, Singapore
Prince of Wales Hospital Hong Kong
King Chulalongkorn Memorial Hospital
Samsung Medical Center, Sungkyunkwan university
Chonnam National University Medical School
Yonsei University College of Medicine
Dong-A University, College of Medicine
Taipei Veterans General Hospital
University of Ulsan College of Medicine
College of Medicine, Pochon CHA University
National University Cancer Institute
Korea University Anam Hospital
Pusan National University Hospital
Ulsan University Hospital
Siriraj Hospital
Yonsei Cancer Hospital
Chungbuk National University Hospital
Seoul National University Bundang Hospital
Inje University Paik Hospital
National Cheng Kung University Hospital
National Taiwan University Hospital
Asan Medical Center
National Cancer Centre, Singapore
Prince of Wales Hospital Hong Kong
King Chulalongkorn Memorial Hospital
Samsung Medical Center, Sungkyunkwan university
Chonnam National University Medical School
Yonsei University College of Medicine
Dong-A University, College of Medicine
Taipei Veterans General Hospital
University of Ulsan College of Medicine
College of Medicine, Pochon CHA University
National University Cancer Institute
Corresponding Author(s)
Other Contributor(s)
Abstract
Introduction: Atezolizumab plus bevacizumab is a commonly used first-line regimen for advanced hepatocellular carcinoma (HCC) treatment owing to its superior outcomes compared to sorafenib. However, optimal subsequent treatment options for patients with HCC who progressed on first-line atezolizumab plus bevacizumab remain unclear. Methods: This multinational, multi-institutional, retrospective study included patients with HCC from 22 centers in five Asia-Pacific countries who were treated with first-line atezolizumab plus bevacizumab, which was discontinued for any reason. The endpoints included progression-free survival (PFS) and overall survival (OS) according to patient characteristics and second-line regimens. Results: Between June 2016 and May 2023, 1,141 patients were treated with first-line atezolizumab plus bevacizumab, of whom 629 (55.1%) received subsequent treatment. Sorafenib and lenvatinib were the most commonly administered second-line regimens (53.9% and 25.6%, respectively). Overall, the median PFS and OS were 2.9 and 8.0 months, respectively. Lenvatinib had longer PFS (4.0 vs. 2.3 months) and OS (8.0 vs. 6.3 months) than sorafenib. Patients treated with tyrosine kinase inhibitor (TKI) plus immune checkpoint inhibitor (ICI) (n = 50, 8.3%) showed PFS and OS of 5.4 and 12.6 months, respectively. Lower tumor burden and lenvatinib or TKI plus ICI use were associated with longer second-line PFS. Preserved liver function was associated with improved OS. Conclusions: In patients with HCC who progressed on first-line atezolizumab plus bevacizumab, sorafenib and lenvatinib were the most commonly used second-line regimens in Asia-Pacific countries, with lenvatinib resulting in longer OS than sorafenib. The second-line TKI plus ICI combination exhibited promising efficacy, suggesting the potential role of continuing ICIs beyond disease progression.