Lo Prinzi Federica, Rossari Federico, Silletta Marianna, Camera Silvia, Foti Silvia, Persano Mara, Vitiello Francesco, Di Giacomo Emanuela, Polito Mariam Grazia, Rimini Margherita, Casadei-Gardini Andrea
Operative Research Unit of Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
Department of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy.
Target Oncol. 2025 Jun 23. doi: 10.1007/s11523-025-01161-5.
There are no studies that directly compare atezolizumab plus bevacizumab and tremelimumab plus durvalumab (STRIDE), two first-line options for the systemic therapy of advanced hepatocarcinoma (HCC).
We conducted a real-world retrospective analysis to compare the clinical efficacies of these two regimens.
Using TriNetX data on patients with HCC at Barcelona Clinic Liver Cancer (BCLC) stages B or C, the analysis included patients treated with atezolizumab plus bevacizumab or with the STRIDE regimen. The primary endpoint was overall survival (OS) comparing the two treatment groups.
Before applying propensity-score matching, a total of 2,307 consecutive patients were identified. Among them, 1,998 received atezolizumab plus bevacizumab, and 309 were treated with STRIDE. After matching, 618 patients remained, with 309 in each cohort. The analysis showed no significant difference between the two treatments: median OS was 15.4 months (95% confidence interval (CI) 14.7-51.6) and 15.5 months (95% CI 15.0-47.0) for patients treated with atezolizumab plus bevacizumab versus STRIDE, respectively (HR 0.94; 95% CI 0.73-1.22, p = 0.67). The univariate analyses of baseline clinical and laboratory characteristics indicated that the only differentiating factor between the two regimens was better survival for females receiving atezolizumab plus bevacizumab (HR 1.77; 95% CI 1.00-3.16, p = 0.04).
Atezolizumab plus bevacizumab and STRIDE demonstrated no statistical difference in OS, showing them to be equally valid alternatives for patients with advanced HCC.
尚无研究直接比较阿替利珠单抗联合贝伐珠单抗与曲美木单抗联合度伐利尤单抗（STRIDE）这两种晚期肝癌（HCC）全身治疗的一线方案。
我们进行了一项真实世界回顾性分析，以比较这两种方案的临床疗效。
利用TriNetX数据库中巴塞罗那临床肝癌（BCLC）分期为B或C期的HCC患者数据，分析纳入接受阿替利珠单抗联合贝伐珠单抗或STRIDE方案治疗的患者。主要终点是比较两个治疗组的总生存期（OS）。
在应用倾向评分匹配之前，共识别出2307例连续患者。其中，1998例接受阿替利珠单抗联合贝伐珠单抗治疗，309例接受STRIDE方案治疗。匹配后，剩余618例患者，每组各309例。分析显示两种治疗之间无显著差异：接受阿替利珠单抗联合贝伐珠单抗治疗与接受STRIDE方案治疗的患者的中位OS分别为15.4个月（95%置信区间（CI）14.7 - 51.6）和15.5个月（95%CI 15.0 - 47.0）（风险比0.94；95%CI 0.73 - 1.22，p = 0.67）。对基线临床和实验室特征的单因素分析表明，两种方案之间唯一的区别因素是接受阿替利珠单抗联合贝伐珠单抗治疗的女性患者生存期更好（风险比1.77；95%CI 1.00 - 3.16，p = 0.0
阿替利珠单抗联合贝伐珠单抗与STRIDE方案在总生存期方面无统计学差异，表明它们是晚期HCC患者同样有效的替代方案。
