Three‐Year Long‐Term Outcomes in Patients With Unresectable Hepatocellular Carcinoma Treated With Atezolizumab Plus Bevacizumab Treatment in Clinical Practice

BACKGROUND: Findings regarding long-term outcomes of unresectable hepatocellular carcinoma (uHCC) patients treated with atezolizumab and bevacizumab (Atez/Bev) have yet to be reported. This study was performed to evaluate results regarding 3 year survival of such patients treated in real-world clinical settings. METHODS: This multicenter retrospective study included 555 patients with Child-Pugh A and BCLC stage B or C, for whom Atez/Bev treatment was initiated in the period from 2020 to 2021. Best treatment response, progression-free survival (PFS), overall survival (OS), post-progression survival (PPS), and immune-related adverse events (irAEs) were analyzed. RESULTS: Median age was 73 years and 80.2% were male. Atez/Bev was given as first-line therapy in 55.3%. Objective response rate (ORR) was 41.3% and disease control rate (DCR) was 79.4%. Median PFS was 6.2 months, while median OS was 21.6 months with a 3 year survival rate of 29.7%. Patients treated with Atez/Bev as first-line therapy showed a higher 3 year survival rate of 35.9%. Post-progression treatment was administered to 54.1% of the patients and median PPS in those was 10.9 months. Conversion therapy was performed in 5.9%. IrAEs occurred in 13.3% (grade 5: 0.7%). CONCLUSIONS: uHCC patients treated with Atez/Bev in clinical practice settings showed good ORR and DCR, as well as favorable long-term survival with a 3 year survival rate of approximately 30%, including 35.9% for first-line users.