Real-World Systemic Treatment Patterns after Atezolizumab and Bevacizumab in Patients with Hepatocellular Carcinoma in the United States

Abstract

Real-world (RW) evidence is needed to evaluate atezolizumab plus bevacizumab (atezo + bev) utilization for hepatocellular carcinoma (HCC) in clinical practice. This retrospective cohort study used administrative claims databases to evaluate treatment patterns in individuals with HCC ≥18 years of age who were initiated on atezo + bev between June 2020 and June 2022. The endpoints of this study were the proportion of individuals who discontinued atezo + bev and received subsequent systemic therapies, time to discontinuation (TTD), and time to next treatment. Overall, 825 individuals were eligible (median age 67 years; 80% male). Over a median follow-up of 15.3 months, most (72%) discontinued atezo + bev, with a median TTD of 3.5 months. A minority (19%) received subsequent therapies, with the most common second-line agents being lenvatinib (6%), cabozantinib (4%), and nivolumab (4%). The median time from index to next treatment post-atezo + bev was 5.4 months. Further research is needed to identify the patients who are most likely to benefit from atezo + bev as well as later-line HCC therapies to optimize overall survival.

Keywords: chemotherapy; immunotherapy; liver cancer; targeted therapy; treatment patterns.

Figure 1

Study design. HCC diagnosis was required any time prior to the date of atezo + bev initiation (index date). Abbreviations: atezo + bev, atezolizumab plus bevacizumab; HCC, hepatocellular carcinoma.

Figure 2

Time to discontinuation in (A) all individuals and (B) individuals ≥65 years of age over the entire post-index period. Post-index period is defined as the ≥2 months after atezo + bev initiation (index date). Individuals were censored at the end of data availability or the end of study period, whichever came first. Abbreviations: atezo + bev, atezolizumab plus bevacizumab; TTD, time to discontinuation.

Figure 2

Time to discontinuation in (A) all individuals and (B) individuals ≥65 years of age over the entire post-index period. Post-index period is defined as the ≥2 months after atezo + bev initiation (index date). Individuals were censored at the end of data availability or the end of study period, whichever came first. Abbreviations: atezo + bev, atezolizumab plus bevacizumab; TTD, time to discontinuation.