Babu Merin, Komaranchath Ashok Sebastian, Valsan Arun, Warrier Arun R, Mp Rakesh, Jose Wesley M, Haridas Nikhil K, Soman Sumi, Nair Manjima P, Sadasivan Shine, Menon Abhinav, Thabrez Mohammed, Pavithran Keechilat
Department of Medical Oncology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, 682041, India.
Department of Medical Oncology, Aster Medcity, Kochi, Kerala, India.
BMC Cancer. 2025 Jul 1;25(1):1026. doi: 10.1186/s12885-025-14400-9.
Immunotherapy with atezolizumab and bevacizumab is the current first-line standard of care for unresectable hepatocellular carcinoma (HCC). This study aimed to evaluate the safety and efficacy profile of atezolizumab-bevacizumab in the Indian population, as there are limited studies.
All patients diagnosed with advanced HCC who received systemic therapy with atezolizumab bevacizumab as the first- or second-line therapy were included in the study. Data were collected retrospectively from two comprehensive cancer centres between September 2020 and May 2024 by accessing the medical records. As per the IMBrave 150 trial, patients were given atezolizumab 1200 mg and bevacizumab 15 mg/kg intravenously every 3 weeks. Demographic details, adverse events, and radiological data were collected.
We included one hundred and four patients with a median age of 67 years. Majority of the patients had a compensated cirrhosis (n = 77; 74%), while Child Pugh class B cirrhosis was observed in 19 patients (18%), and class C cirrhosis in 3 patients (3%). The median OS was 14.8 (95% CI; 6.8 - 22.9) months and median PFS in the whole cohort was 6.2 months (95% CI; 2.5 - 9.9) monthsGlobally, hepatocellular carcinoma (HCC) ranks sixth in incidence and third among cancer-related dea.
The real-world OS and PFS rates were lower than those of the IMBrave trial, most likely because 43% of our patients did not meet the inclusion criteria. We conclude that the combination of atezolizumab and bevacizumab is a safe and effective option for patients with unresectable hepatocellular carcinoma patients with manageable toxicities.
阿替利珠单抗和贝伐珠单抗免疫疗法是目前不可切除肝细胞癌（HCC）的一线标准治疗方案。由于相关研究有限，本研究旨在评估阿替利珠单抗-贝伐珠单抗在印度人群中的安全性和疗效。
所有被诊断为晚期HCC且接受阿替利珠单抗联合贝伐珠单抗作为一线或二线全身治疗的患者均纳入本研究。通过查阅病历，于2020年9月至2024年5月从两家综合癌症中心回顾性收集数据。按照IMBrave 150试验方案，患者每3周静脉注射阿替利珠单抗1200 mg和贝伐珠单抗15 mg/kg。收集人口统计学细节、不良事件和放射学数据。
我们纳入了104例患者，中位年龄为67岁。大多数患者为代偿性肝硬化（n = 77；74%），19例患者（18%）为Child Pugh B级肝硬化，3例患者（3%）为C级肝硬化。中位总生存期为14.8（95%CI；6.8 - 22.9）个月，整个队列的中位无进展生存期为6.2个月（95%CI；2.5 - 9.9）个月。在全球范围内，肝细胞癌（HCC）的发病率排名第六，在癌症相关死亡中排名第三。
真实世界中的总生存期和无进展生存期低于IMBrave试验，很可能是因为我们43%的患者不符合纳入标准。我们得出结论，对于不可切除的肝细胞癌患者，阿替利珠单抗和贝伐珠单抗联合使用是一种安全有效的选择，毒性可控。
