Clinical Outcomes and Histologic Findings of Patients With Hepatocellular Carcinoma With Durable Partial Response or Durable Stable Disease After Receiving Atezolizumab Plus Bevacizumab.
Journal
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
ISSN
1527-7755
Date Issued
2024
Author(s)
Nicholas, Alan
Soyama, Akihiko
Chen, Tse-Ching
Eguchi, Susumu
Yoshizumi, Tomoharu
Itoh, Shinji
Nakamura, Noriaki
Kosaka, Hisashi
Kaibori, Masaki
Ishii, Takamichi
Hatano, Etsuro
Ogawa, Chikara
Naganuma, Atsushi
Kakizaki, Satoru
Cheng, Chih-Hsien
Lin, Po-Ting
Su, Yung-Yeh
Wu, Chi-Jung
Wang, Hung-Wei
Rau, Kun-Ming
Huang, Yi-Hsiang
Hernandez, Sairy
Lin, Shi-Ming
Finn, Richard S
Kudo, Masatoshi
Abstract
Durable partial response (PR) and durable stable disease (SD) are often seen in patients with hepatocellular carcinoma (HCC) receiving atezolizumab plus bevacizumab (atezo-bev). This study investigates the outcome of these patients and the histopathology of the residual tumors.
The IMbrave150 study's atezo-bev group was analyzed. PR or SD per RECIST v1.1 lasting more than 6 months was defined as durable. For histologic analysis, a comparable real-world group of patients from Japan and Taiwan who had undergone resection of residual tumors after atezo-bev was investigated.
In the IMbrave150 study, 56 (77.8%) of the 72 PRs and 41 (28.5%) of the 144 SDs were considered durable. The median overall survival was not estimable for patients with durable PR and 23.7 months for those with durable SD. The median progression-free survival was 23.2 months for patients with durable PR and 13.2 months for those with durable SD. In the real-world setting, a total of 38 tumors were resected from 32 patients (23 PRs and nine SDs) receiving atezo-bev. Pathologic complete responses (PCRs) were more frequent in PR tumors than SD tumors (57.7% 16.7%, = .034). PCR rate correlated with time from atezo-bev initiation to resection and was 55.6% (5 of 9) for PR tumors resected beyond 8 months after starting atezo-bev, a time practically corresponding to the durable PR definition used for IMbrave150. We found no reliable radiologic features to predict PCR of the residual tumors.
Durable PR patients from the atezo-bev group showed a favorable outcome, which may be partly explained by the high rate of PCR lesions. Early recognition of PCR lesions may help subsequent treatment decision.
Type
journal article