Pretreatment Modified Albumin-Bilirubin Grade Is an Important Predictive Factor Associated with the Therapeutic Response and the Continuation of Atezolizumab plus Bevacizumab Combination Therapy for Patients with Unresectable Hepatocellular Carcinoma.

BACKGROUND

Atezolizumab plus bevacizumab (ATZ + BV) treatment is recommended as the first-line systemic therapy for patients with unresectable hepatocellular carcinoma (u-HCC). This study aimed to investigate the predictive factors of therapeutic response and the continuation of ATZ + BV treatment for u-HCC in a real-world setting.

METHODS

This retrospective study was conducted between January 2021 and April 2022. Twenty-eight patients with u-HCC, who were treated with ATZ + BV, were assessed for their treatment response, continuation, and adverse events (AEs).

RESULTS

Among the 28 patients, 24 were evaluated at the first imaging. The objective response rate (ORR) was 29.2% ( = 7), and 54.2% ( = 13) on the response evaluation criteria in solid tumors (RECIST 1.1) and in the modified RECIST (mRECIST) guidelines, respectively. Comparing the objective response (OR) group ( = 13) and the non-OR group ( = 11), the modified albumin-bilirubin (mALBI) grades 1 and 2a were found to be significant predictive factors for OR ( = 0.021) in the mRECIST guidelines. Among the 28 patients, 17 discontinued their treatment due to AEs. Comparing the treatment continuation ( = 11) and discontinuation groups ( = 17), a Child-Pugh score of five points ( = 0.009) and mALBI grades 1 and 2a ( = 0.020) were predictive factors with significant differences.

CONCLUSIONS

Pretreatment mALBI grades 1 and 2a were the important predictive factors associated with the therapeutic response and the therapeutic continuation of ATZ + BV for patients with u-HCC.