Atezolizumab in Combination with Bevacizumab for the Management of Patients with Hepatocellular Carcinoma in the First-Line Setting: Systematic Literature Review and Meta-Analysis.

Autor:	Vogel A; Hannover Medical School, Hannover, Germany., Finn RS; Division of Hematology Oncology, Department of Medicine, University of California, Los Angeles, CA, USA., Blanchet Zumofen MH; F. Hoffmann-La Roche Ltd., Basel, Switzerland., Heuser C; F. Hoffmann-La Roche Ltd., Basel, Switzerland., Alvarez JS; F. Hoffmann-La Roche Ltd., Basel, Switzerland., Leibfried M; Genentech Inc., South San Francisco, CA, USA., Mitchell CR; Mtech Access Limited, Bicester, UK., Batson S; Mtech Access Limited, Bicester, UK., Redhead G; Mtech Access Limited, Bicester, UK., Gaillard VE; Hannover Medical School, Hannover, Germany., Kudo M; Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan.
Jazyk:	angličtina
Zdroj:	Liver cancer [Liver Cancer] 2023 Jul 29; Vol. 12 (6), pp. 510-520. Date of Electronic Publication: 2023 Jul 29 (Print Publication: 2023).
DOI:	10.1159/000533166
Abstrakt:	Background: In 2020, atezolizumab-bevacizumab became the new standard of care (SOC) for first-line unresectable hepatocellular carcinoma (HCC) patients, following a decade where sorafenib was the preferred first-line treatment. In the last few years, a number of novel systemic treatments with non-inferiority and superiority to sorafenib have been approved as first-line treatments. Objectives: The objective of this systematic literature review (SLR) and network meta-analysis (NMA) was to compare randomised controlled trial evidence for atezolizumab-bevacizumab with globally relevant pharmacological comparators for first-line treatment of patients with unresectable HCC. Methods: Randomised controlled trials investigating first-line treatment of HCC in adults with no prior systemic treatment were eligible for inclusion into the SLR and were retrieved from Embase, MEDLINE, and Evidence-Based Medicine (EBM) Reviews. Interventions of interest for the NMA included atezolizumab-bevacizumab, sorafenib, lenvatinib, durvalumab (including in combination with tremelimumab), cabozantinib (including in combination with atezolizumab), camrelizumab (including in combination with rivoceranib), pembrolizumab (including in combination with lenvatinib), and tislelizumab. Random effects NMA was conducted for survival endpoints within a Bayesian framework with an informative prior distribution for between-study heterogeneity. The hazard ratios for relative treatment effect were estimated with 95% credible intervals (CrIs). Results: The SLR identified 49 studies, of which eight formed a connected evidence network permitting the indirect treatment comparison of atezolizumab-bevacizumab with comparators of interest. The indirect comparisons suggested an improved overall survival (OS) with atezolizumab-bevacizumab versus most comparators. All indirect treatment comparison results for atezolizumab-bevacizumab included the null value within the 95% CrI ( n = 1) for OS and progression-free survival (PFS). Conclusions: The results of the NMA indicate atezolizumab-bevacizumab is associated with superior or comparable OS and PFS together with a manageable safety profile compared with globally relevant comparators in the unresected HCC indication. The findings support that atezolizumab-bevacizumab remains SOC for the management of first-line unresectable HCC patients. Competing Interests: Arndt Vogel had been directly paid honoraria and has been paid consulting or advisory roles for AstraZeneca, BeiGene, Boehringer Mannheim, BMS, BTG, EISAI, GSK, Incyte, Ipsen, MSD, Hoffmann-La Roche, Servier, Sirtex, and Taiho. Richard Finn has been paid consulting/advisory roles for AstraZeneca, Bayer, Bristol Myers Squibb, Eisai, Exelixis, Eli Lilly, Merck, Hoffmann-La Roche, Genentech, CStone, and Hengrui. His institution has conducted research for Bayer, Bristol Myers Squibb, Eisai, Eli Lilly, Merck, Pfizer, Hoffmann-La Roche, and Genentech. Dr. Finn has participated in speakers’ bureau for Genentech. Masatoshi Kudo had been directly paid honoraria by Eisai, Chugai, Eli Lilly, Takeda, and Bayer. His institution has conducted research for Otsuka, Chugai, GE Healthcare, Taiho, AbbVie, EA Pharma, and Eisai. Marie-Helene Blanchet Zumofen, Carolina Heuser, Javier Sanchez Alvarez, and Vincent E. Gaillard are currently or have been during the past 2 years employed by Hoffmann-La Roche Ltd. Michael Leibfried is employed by Genentech Inc. Marie-Helene Blanchet Zumofen, Carolina Heuser, Javier Sanchez Alvarez, Vincent E. Gaillard, and Michael Leibfried own stocks (currently or in the past 2 years) in Hoffmann-La Roche Ltd. Catherine R. Mitchell, Sarah Batson, and Gabrielle Redhead have no conflict of interest. (© 2023 The Author(s). Published by S. Karger AG, Basel.)
Databáze:	MEDLINE
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