Safety and Efficacy of Atezolizumab/Bevacizumab in unresectable Hepatocellular Carcinoma - a multicentric study

Purpose: Immunotherapy with atezolizumab and bevacizumab is the current first-line standard of care for unresectable hepatocellular carcinoma (HCC). This study aimed to evaluate the safety and efficacy profile of atezolizumab-bevacizumab in our Indian population, as there are limited studies. Patients and methods: All patients diagnosed with advanced HCC who received systemic therapy with atezolizumab bevacizumab as the first- or second-line therapy were included in the study. Data were collected retrospectively from two comprehensive cancer centres between September 2020 and May 2024 by accessing the medical records. As per the IMBrave 150 trial, patients were given atezolizumab 1200 mg and bevacizumab 15 mg/kg intravenously every 3 weeks. Demographic details, adverse events, and radiological data were collected. Results: We included one hundred and four patients with a median age of 67 years. Majority of the patients had a compensated cirrhosis (n = 77; 74%), while Child Pugh class B cirrhosis was observed in 19 patients (18%), and class C cirrhosis in 3 patients (3%). The median OS was 14.8 (95% CI; 6.8 – 22.9) months and median PFS in the whole cohort was 6.2 months (95% CI; 2.5 – 9.9) months. Conclusion: The real-world OS and PFS rates were lower than those of the IMBrave trial, most likely because 43% of our patients did not meet the inclusion criteria. We conclude that the combination of atezolizumab and bevacizumab is a safe and effective option for patients with unresectable hepatocellular carcinoma patients with manageable toxicities.