Long-term survival of patients who received atezolizumab plus bevacizumab treatment for advanced hepatocellular carcinoma.
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BACKGROUND: Immunotherapy combinations, such as atezolizumab plus bevacizumab (Atezo-Bev) or durvalumab plus tremelimumab, have been established as standard treatments for patients with advanced hepatocellular carcinoma (HCC). Durable responses and long-term survival have been reported following dual immunotherapy. However, the long-term outcomes associated with Atezo-Bev treatment remain unclear. METHODS: To evaluate survival outcomes, we retrospectively analyzed medical records for patients with Child-Pugh class A liver function who received first-line Atezo-Bev for advanced HCC from January 2018 to May 2021 from four medical centers in Taiwan. RESULTS: A total of 54 patients were included in the analysis. This cohort was predominantly male (90.7%) and had a median age of 65 years. After a median follow-up period of 61.9 months, the median overall survival (OS) was 19.6 months (95% confidence interval, 10.1-20.1 months). The OS rates at 36, 48, and 60 months were 31.6%, 19.6%, and 19.6%, respectively. Younger age (≤70 years), absence of intrahepatic tumors, absence of macrovascular invasion (MVI), and Albumin-Bilirubin (ALBI) grade 1 liver function were associated with long-term survival (>36 months). A multivariate analysis revealed the absence of intrahepatic tumors (odds ratio [OR] = 5.36, p = 0.047) and ALBI grade 1 (OR = 10.02, p = 0.037) as independent predictors of long-term survival. Among patients achieving complete or partial response, the 60-month OS rate was 47.4%. CONCLUSIONS: Among patients with advanced HCC treated with first-line Atezo-Bev, approximately 30% survived beyond 3 years. The absence of intrahepatic tumors and preserved liver function were predictive of such prolonged survival.