Characterization of response to atezolizumab + bevacizumab versus sorafenib for hepatocellular carcinoma: Results from the IMbrave150 trial

  • Riad Salem
    Department of Radiology Feinberg School of Medicine Northwestern University Evanston IL USA
  • Daneng Li
    Department of Medical Oncology City of Hope Comprehensive Cancer Center and Beckman Research Institute Duarte CA USA
  • Nicolas Sommer
    Genentech, Inc South San Francisco CA USA
  • Sairy Hernandez
    Genentech, Inc South San Francisco CA USA
  • Wendy Verret
    Genentech, Inc South San Francisco CA USA
  • Beiying Ding
    Genentech, Inc South San Francisco CA USA
  • Riccardo Lencioni
    Department of Radiology University of Pisa School of Medicine Pisa Italy

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<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>IMbrave150 is a phase III trial that assessed atezolizumab + bevacizumab (ATEZO/BEV) versus sorafenib (SOR) in patients with unresectable hepatocellular carcinoma (HCC) and demonstrated a significant improvement in clinical outcomes. Exploratory analyses characterized objective response rate (ORR), depth (DpR), and duration of response (DoR), and patients with a complete response (CR).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Patients were randomized 2:1 to intravenous ATEZO (1200 mg) + BEV (15 mg/kg) every 3 weeks or oral SOR (400 mg) twice daily. Tumors were evaluated using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) and HCC‐modified RECIST (mRECIST). ORR by prior treatment and largest baseline liver lesion size, DoR, time to response (TTR), and complete response (TTCR) were analyzed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>For both criteria, responses favored ATEZO/BEV versus SOR regardless of prior treatment and in patients with lesions ≥3 cm. Median TTR was 2.8 months per RECIST 1.1 (range: 1.2–12.3 months) and 2.8 months per mRECIST (range: 1.1–12.3 months) with ATEZO/BEV. Patients receiving ATEZO/BEV had a greater DpR, per both criteria, across baseline liver lesion sizes. Characteristics of complete responders were similar to those of the intent‐to‐treat population. In complete responders receiving ATEZO/BEV per mRECIST versus RECIST 1.1, respectively, median TTCR was shorter (5.5 vs. 7.0 months), mean baseline sum of lesion diameter was longer (5.0 [SD, 5.1] vs. 2.6 [SD, 1.4] cm), and mean largest liver lesion size was larger (4.8 [SD, 4.2] vs. 2.3 [SD, 1.0] cm).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>These data highlight the improved ORR, DpR, and CR rates with ATEZO/BEV in unresectable HCC.</jats:p></jats:sec>

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