The European Society for Medical Oncology has updated its guidelines on the treatment of hepatocellular carcinoma (HCC) to include recommendations on the use of atezolizumab and bevacizumab.
The updated guidelines recommend that the combination be considered as first-line treatment of Barcelona clinic liver cancer (BCLC) B or C hepatoma in untreated patients.
A January 2020 eUpdate deferred a definitive decision on immunotherapy for this patient group until more mature data were available from randomised controlled trials. Since then, further findings from the phase 3 IMbrave 150 trial have been published and show that the combination significantly prolonged overall survival (OS) and progression-free survival (PFS) compared to sorafenib.
At median follow-up of 8.6 months, median OS with the combination was not estimable (NE) vs 13.2 months with sorafenib (hazard ratio [HR] 0.58; 95% CI 0.42-0.79; P=.0006). Median PFS was 6.8 months versus 4.5 months, respectively (HR 0.59; 95% CI 0.47-0.76; P<.0001>
In view of the positive trial findings, ESMO now advises that atezolizumab and bevacizumab be considered as first-line therapy for this patient population (FDA-approved, not EMA-approved).