Safety and efficacy of atezolizumab plus bevacizumab in elderly patients with hepatocellular carcinoma: A multicenter analysis

<jats:title>Abstract</jats:title><jats:sec><jats:title>Aim</jats:title><jats:p>The safety and efficacy of atezolizumab plus bevacizumab (Atez/Bev) in elderly patients with unresectable hepatocellular carcinoma (HCC) have not been sufficiently investigated.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A total of 317 patients with HCC treated with Atez/Bev were studied. We compared the survival and frequency of adverse events in elderly versus non‐elderly patients with HCC who were treated with Atez/Bev using an analysis of inverse probability weighting (IPW).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Univariate analysis adjusted with IPW showed that being elderly is not associated with worse overall or progression‐free survival (hazard ratio [HR], 1.239; 95% confidence interval [CI], 0.640–2.399; <jats:italic>p</jats:italic> = 0.526 and HR, 1.256; 95% CI, 0.871–1.811; <jats:italic>p</jats:italic> = 0.223, respectively). Regarding treatment‐related adverse events, any grade of fatigue, proteinuria, decreased appetite, hypertension, and liver injury occurred in ≥10% of patients. There were no significant differences in treatment‐related adverse events between the elderly and non‐elderly groups. In a subgroup analysis of elderly patients aged 75–79, 80–84, or ≥ 85 years, there were no significant differences in cumulative overall or progression‐free survival among these age groups (<jats:italic>p</jats:italic> = 0.960 and 0.566, respectively). In addition, there were no significant differences in treatment‐related adverse events among these three age groups, except for proteinuria of any grade. In a subgroup analysis of patients treated with Atez/Bev as first‐line systemic therapy, there were no significant differences in cumulative overall or progression‐free survival between the elderly and non‐elderly groups (<jats:italic>p</jats:italic> = 0.728 and 0.805, respectively).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Atez/Bev can be used efficaciously and safely in spite of age in patients with unresectable HCC.</jats:p></jats:sec>