Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma
| Autor: | Derek-Zhen Xu, Tae-You Kim, Juan Liu, Andrew X. Zhu, Michel Ducreux, Ho Yeong Lim, Peter R. Galle, Valeriy Breder, Masafumi Ikeda, Wendy Verret, Masatoshi Kudo, Richard S. Finn, Philippe Merle, IMbrave Investigators, Chen Huang, Shukui Qin, Sairy Hernandez, Daneng Li, Ann-Lii Cheng, Yulei Wang, Sohail M. Mulla, Ahmed O Kaseb |
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| Rok vydání: | 2020 |
| Předmět: |
Oncology
Male medicine.medical_specialty Carcinoma Hepatocellular Bevacizumab Programmed Cell Death 1 Receptor Kaplan-Meier Estimate 030204 cardiovascular system & hematology Antibodies Monoclonal Humanized 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Atezolizumab Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Carcinoma Humans 030212 general & internal medicine Aged Antitumor activity business.industry Liver Neoplasms General Medicine Middle Aged medicine.disease Survival Analysis Intention to Treat Analysis Clinical trial Multicenter study chemistry Hepatocellular carcinoma Quality of Life Female Lenvatinib business medicine.drug |
| Zdroj: | The New England journal of medicine. 382(20) |
| ISSN: | 1533-4406 |
| Popis: | The combination of atezolizumab and bevacizumab showed encouraging antitumor activity and safety in a phase 1b trial involving patients with unresectable hepatocellular carcinoma.In a global, open-label, phase 3 trial, patients with unresectable hepatocellular carcinoma who had not previously received systemic treatment were randomly assigned in a 2:1 ratio to receive either atezolizumab plus bevacizumab or sorafenib until unacceptable toxic effects occurred or there was a loss of clinical benefit. The coprimary end points were overall survival and progression-free survival in the intention-to-treat population, as assessed at an independent review facility according to Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1).The intention-to-treat population included 336 patients in the atezolizumab-bevacizumab group and 165 patients in the sorafenib group. At the time of the primary analysis (August 29, 2019), the hazard ratio for death with atezolizumab-bevacizumab as compared with sorafenib was 0.58 (95% confidence interval [CI], 0.42 to 0.79; P0.001). Overall survival at 12 months was 67.2% (95% CI, 61.3 to 73.1) with atezolizumab-bevacizumab and 54.6% (95% CI, 45.2 to 64.0) with sorafenib. Median progression-free survival was 6.8 months (95% CI, 5.7 to 8.3) and 4.3 months (95% CI, 4.0 to 5.6) in the respective groups (hazard ratio for disease progression or death, 0.59; 95% CI, 0.47 to 0.76; P0.001). Grade 3 or 4 adverse events occurred in 56.5% of 329 patients who received at least one dose of atezolizumab-bevacizumab and in 55.1% of 156 patients who received at least one dose of sorafenib. Grade 3 or 4 hypertension occurred in 15.2% of patients in the atezolizumab-bevacizumab group; however, other high-grade toxic effects were infrequent.In patients with unresectable hepatocellular carcinoma, atezolizumab combined with bevacizumab resulted in better overall and progression-free survival outcomes than sorafenib. (Funded by F. Hoffmann-La Roche/Genentech; ClinicalTrials.gov number, NCT03434379.). |
| Databáze: | OpenAIRE |
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