Affiliation:
1. Department of Medical Oncology, CHA Bundang Medical Center CHA University Seongnam South Korea
2. Department of Radiology, CHA Bundang Medical Center CHA University Seongnam South Korea
3. Department of Hematology‐Oncology Ulsan University Hospital Ulsan South Korea
4. State Key Laboratory of Translational Oncology; Department of Clinical Oncology The Chinese University of Hong Kong Hong Kong People's Republic of China
5. Department of Clinical Oncology, Sir YK Pao Centre for Cancer The Chinese University of Hong Kong Hong Kong People's Republic of China
6. F. Hoffmann‐La Roche Ltd. Basel Switzerland
Abstract
AbstractBackground and AimsAnti‐programmed death 1 (PD‐1) monotherapy triggers various responses by each organ. In advanced hepatocellular carcinoma (HCC), while extrahepatic lesions demonstrate objective response rates (ORR) of 20%–40%, only 10% of intrahepatic lesions respond. Although first‐line atezolizumab/bevacizumab has shown survival benefits in advanced HCC, organ‐specific responses remain unexplored. Therefore, we aimed to assess organ‐specific responses in patients with advanced HCC receiving atezolizumab/bevacizumab.MethodsThis retrospective, multicenter, observational study included patients who received first‐line atezolizumab/bevacizumab for advanced HCC. Patients with Child‐Pugh class A, measurable tumour lesions and serial imaging available for response evaluation were eligible.ResultsBetween May 2020 and June 2021, 131 patients (median age: 62) from three cancer referral institutions were included. Ninety‐one had hepatitis B (69.5%), 108 were at Barcelona clinic liver cancer stage C (82.4%), and 78 had extrahepatic metastasis (59.5%). After a median follow‐up of 10.1 months, median progression‐free survival was 6.8 months (95% confidence interval [CI], 4.6–9.2), median overall survival remained unreached (95% CI, range unavailable) and the ORR was 29.0%. Among 270 individual tumour lesions, the liver was the most commonly involved organ (n = 158). Atezolizumab/bevacizumab induced ORR of 27.8%, 42.2%, 29.1% and 21.0% for liver, lymph nodes, lungs and other sites, respectively. The organ‐specific response rate for intrahepatic tumours decreased with increasing size (35.6%: <5 cm, 15.0%: ≥ 5 cm).ConclusionsUnlike anti‐PD‐1 monotherapy, atezolizumab/bevacizumab demonstrated favourable responses in intrahepatic lesions, comparable to those in extrahepatic lesions, and may potentially overcome the immune‐tolerant hepatic microenvironment in patients with advanced HCC.
Funder
Ministry of Science and ICT, South Korea