Patient-reported outcomes (PROs) were better with atezolizumab plus bevacizumab than with sorafenib monotherapy in patients with advanced hepatocellular carcinoma (HCC), according to research published in The Lancet Oncology.1

The phase 3 IMbrave150 trial (ClinicalTrials.gov Identifier: NCT03434379) was designed to compare the 2 treatments in patients with systemic, treatment-naive, unresectable HCC. Prior results showed significant improvements in overall survival and progression-free survival with atezolizumab plus bevacizumab over sorafenib monotherapy.2

For the current analysis, researchers assessed PROs for 309 patients in the atezolizumab-bevacizumab arm and 145 patients in the sorafenib arm. PROs were evaluated using the European Organization Research and Treatment of Cancer (EORTC) quality-of-life questionnaire for cancer (QLQ-C30) and quality-of-life questionnaire for HCC (QLQ-HCC18).

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The median follow-up was 8.6 months. Completion rates for the QLQ-C30 and QLQ-HCC18 were 90% or greater for at least 20 of 24 treatment cycles in both arms.

Compared with sorafenib, atezolizumab plus bevacizumab was associated with a reduced risk of deterioration in all QLQ-C30 generic cancer symptoms, including:

  • Appetite loss — hazard ratio (HR), 0.57 (95% CI, 0.40-0.81)
  • Diarrhea — HR, 0.23 (95% CI, 0.16-0.34)
  • Fatigue — HR, 0.61 (95% CI, 0.46-0.81)
  • Pain — HR, 0.46 (95% CI, 0.34-0.62).

On the QLQ-HCC18, atezolizumab plus bevacizumab was associated with improvements in fatigue (HR, 0.60; 95% CI, 0.45-0.80) and pain (HR, 0.65; 95% CI, 0.46-0.92), but not jaundice (HR, 0.76; 95% CI, 0.55-1.07), when compared with sorafenib.

The mean QLQ-C30 score changes from baseline to day 1 of cycle 5 in the atezolizumab-bevacizumab arm compared with the sorafenib arm were as follows:

  • Quality of life — -3.29 vs -5.83
  • Role functioning — -4.02 vs -9.76
  • Physical functioning — -3.77 vs -7.60.

“Patient-reported outcome data from this trial complement the significant and clinically meaningful overall survival and progression-free survival benefits seen with atezolizumab plus bevacizumab versus sorafenib in patients with unresectable hepatocellular carcinoma who have not received previous systemic therapy,” the study authors wrote.

“[The results] strengthen the positive benefit-risk profile of atezolizumab plus bevacizumab compared with that of sorafenib and provide further justification for why this combination therapy should become the standard of care for these patients,” they concluded.

Disclosures: This research was supported by F Hoffmann-La Roche and Genentech, which also provided the study drugs. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

  1. Galle PR, Finn RS, Qin S, et al. Patient-reported outcomes with atezolizumab plus bevacizumab versus sorafenib in patients with unresectable hepatocellular carcinoma (IMbrave150): an open-label, randomised, phase 3 trial. Lancet Oncol. 2021;22(7):991-1001. doi:10.1016/S1470-2045(21)00151-0
  2. Finn RS, Qin S, Ikeda M, et al. Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma. N Engl J Med. 2020;382: 1894–905. doi:10.1056/NEJMoa1915745

Topics:

Gastrointestinal Cancer Hepatocellular Carcinoma