Background: The combination of atezolizumab-bevacizumab has been proven to be superior to sorafenib for the treatment of unresectable hepatocellular carcinoma not amenable to locoregional treatments, becoming the standard of care of systemic therapy. Aim: This study aimed at assessing real-world feasibility of atezolizumab-bevacizumab in patients treated with tyrosine-kinase inhibitors. Methods: Among 1447 patients treated with tyrosine-kinase inhibitors from January 2010 to December 2020, we assessed the percentage of those potentially eligible to atezolizumab-bevacizumab (according to IMbrave-150 trial criteria), and the overall survival of eligible and non-eligible patients. Results: 422 (29%) patients were qualified for atezolizumab-bevacizumab therapy. The main exclusion causes were Child-Pugh class and Performance Status. Adopting the more permissive inclusion criteria of SHARP trial, 535 patients became eligible. The median overall survival of tyrosine-kinase inhibitors patients was 14.9 months, longer in eligible patients than in their counterpart due to better baseline liver function and oncological features. Conclusion: Real-world data indicate that less than one-third of hepatocellular carcinoma patients treated with tyrosine-kinase inhibitors are potentially eligible to atezolizumab-bevacizumab according to the registration trial criteria. These patients have a longer survival than the non-eligible ones. If the selection criteria of atezolizumab-bevacizumab trial are maintained in clinical practice, tyrosine-kinase inhibitors will remain the most used systemic therapy for hepatocellular carcinoma patients.
Potential feasibility of atezolizumab-bevacizumab therapy in patients with hepatocellular carcinoma treated with tyrosine-kinase inhibitors / Stefanini, B.; Bucci, L.; Santi, V.; Reggidori, N.; Rampoldi, D.; Lani, L.; Granito, A.; Sangiovanni, A.; Cabibbo, G.; Farinati, F.; Campani, C.; Foschi, F. G.; Svegliati-Baroni, G.; Raimondo, G.; Gasbarrini, A.; Mega, A.; Biasini, E.; Sacco, R.; Morisco, F.; Caturelli, E.; Vidili, G.; Azzaroli, F.; Giannini, E. G.; Rapaccini, G. L.; Brunetto, M. R.; Masotto, A.; Nardone, G.; Di Marco, M.; Magalotti, D.; Trevisani, F.; Biselli, M.; Caraceni, P.; Gramenzi, A.; Tovoli, F.; Muratori, L.; Benevento, F.; Allegrini, G.; Camma, C.; Celsa, C.; Giuffrida, P.; Stornello, C.; Grova, M.; Giacchetto, C. M.; Rancatore, G.; Grassini, M. V.; Adotti, V.; Gitto, S.; Marra, F.; Rosi, M.; Bevilacqua, V.; Borghi, A.; Gardini, A. C.; Conti, F.; Dall'Aglio, A. C.; Ercolani, G.; Mirici, F.; de Matthaeis, N.; Ponziani, F. R.; Missale, G.; Olivani, A.; Guarino, M.; Cossiga, V.; Capasso, M.; Cela, E. M.; Facciorusso, A.; Lauria, V.; Ghittoni, G.; Pelecca, G.; Chegai, F.; Coratella, F.; Ortenzi, M.; Dell'Isola, S.; Franze, M. S.; Saitta, C.; Sauchella, A.; Dajti, E.; Ravaioli, F.; Pieri, G.; Torres, M. C. P.; Oliveri, F.; Ricco, G.; Romagnoli, V.; Inno, A.; Marchetti, F.; Coccoli, P.; Malerba, A.; Cappelli, A.; Golfieri, R.; Mosconi, C.; Matteo, Renzulli. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 54:11(2022), pp. 1563-1572. [10.1016/j.dld.2022.07.003]
Potential feasibility of atezolizumab-bevacizumab therapy in patients with hepatocellular carcinoma treated with tyrosine-kinase inhibitors
Sangiovanni A.;Morisco F.;Nardone G.;Guarino M.;Cossiga V.;Romagnoli V.;Coccoli P.;Malerba A.;
2022
Abstract
Background: The combination of atezolizumab-bevacizumab has been proven to be superior to sorafenib for the treatment of unresectable hepatocellular carcinoma not amenable to locoregional treatments, becoming the standard of care of systemic therapy. Aim: This study aimed at assessing real-world feasibility of atezolizumab-bevacizumab in patients treated with tyrosine-kinase inhibitors. Methods: Among 1447 patients treated with tyrosine-kinase inhibitors from January 2010 to December 2020, we assessed the percentage of those potentially eligible to atezolizumab-bevacizumab (according to IMbrave-150 trial criteria), and the overall survival of eligible and non-eligible patients. Results: 422 (29%) patients were qualified for atezolizumab-bevacizumab therapy. The main exclusion causes were Child-Pugh class and Performance Status. Adopting the more permissive inclusion criteria of SHARP trial, 535 patients became eligible. The median overall survival of tyrosine-kinase inhibitors patients was 14.9 months, longer in eligible patients than in their counterpart due to better baseline liver function and oncological features. Conclusion: Real-world data indicate that less than one-third of hepatocellular carcinoma patients treated with tyrosine-kinase inhibitors are potentially eligible to atezolizumab-bevacizumab according to the registration trial criteria. These patients have a longer survival than the non-eligible ones. If the selection criteria of atezolizumab-bevacizumab trial are maintained in clinical practice, tyrosine-kinase inhibitors will remain the most used systemic therapy for hepatocellular carcinoma patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
