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Comparative Study
. 2025 Jul;20(4):707-713.
doi: 10.1007/s11523-025-01161-5. Epub 2025 Jun 23.

Comparative Effectiveness of Atezolizumab Plus Bevacizumab Versus Tremelimumab Plus Durvalumab in Patients with Hepatocellular Carcinoma (HCC) in a Real-World Setting

Federica Lo Prinzi  1 , Federico Rossari  2 , Marianna Silletta  1 , Silvia Camera  2 , Silvia Foti  2 , Mara Persano  2 , Francesco Vitiello  2 , Emanuela Di Giacomo  1 , Mariam Grazia Polito  1 , Margherita Rimini #  2 , Andrea Casadei-Gardini  3
Affiliations
Comparative Study

Comparative Effectiveness of Atezolizumab Plus Bevacizumab Versus Tremelimumab Plus Durvalumab in Patients with Hepatocellular Carcinoma (HCC) in a Real-World Setting

Federica Lo Prinzi et al. Target Oncol. 2025 Jul.

Abstract

Background: There are no studies that directly compare atezolizumab plus bevacizumab and tremelimumab plus durvalumab (STRIDE), two first-line options for the systemic therapy of advanced hepatocarcinoma (HCC).

Objective: We conducted a real-world retrospective analysis to compare the clinical efficacies of these two regimens.

Patients and methods: Using TriNetX data on patients with HCC at Barcelona Clinic Liver Cancer (BCLC) stages B or C, the analysis included patients treated with atezolizumab plus bevacizumab or with the STRIDE regimen. The primary endpoint was overall survival (OS) comparing the two treatment groups.

Results: Before applying propensity-score matching, a total of 2,307 consecutive patients were identified. Among them, 1,998 received atezolizumab plus bevacizumab, and 309 were treated with STRIDE. After matching, 618 patients remained, with 309 in each cohort. The analysis showed no significant difference between the two treatments: median OS was 15.4 months (95% confidence interval (CI) 14.7-51.6) and 15.5 months (95% CI 15.0-47.0) for patients treated with atezolizumab plus bevacizumab versus STRIDE, respectively (HR 0.94; 95% CI 0.73-1.22, p = 0.67). The univariate analyses of baseline clinical and laboratory characteristics indicated that the only differentiating factor between the two regimens was better survival for females receiving atezolizumab plus bevacizumab (HR 1.77; 95% CI 1.00-3.16, p = 0.04).

Conclusions: Atezolizumab plus bevacizumab and STRIDE demonstrated no statistical difference in OS, showing them to be equally valid alternatives for patients with advanced HCC.

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Conflict of interest statement

Declarations. Funding: No external funding was used in the preparation of this article. Conflicts of interest/competing interests: Andrea Casadei Gardini reports consulting fees from AstraZeneca, Bayer, BMS, Eisai, Incyte, Ipsen, IQVIA, MSD, Roche, Servier ; lecture fees from AstraZeneca, Bayer, BMS, Eisai, Incyte, Ipsen, Roche, Servier; travel expenses from AstraZeneca; research grants (to Institution) from AstraZeneca, Eisai. Federica Lo Prinzi, Federico Rossari, Marianna Silletta, Silvia Camera, Silvia Foti, Mara Persano, Francesco Vitiello, Emanuela Di Giacomo, Mariam Grazia Polito, and Margherita Rimini declare that they have no conflicts of interest that might be relevant to the contents of this article. Ethics approval: All electronic health record (EHR) data were obtained through TriNetX and were de-identified by them. We accessed this data as part of a no-cost collaboration agreement. To protect patient privacy, some EHR entries were obfuscated by TriNetX. No human subjects were directly involved in this study, and it is not possible to re-identify any patients from the data used. Consent to participate: Not applicable Consent to publish: Not applicable. Availability of data and material: Data supporting the results of this study are not publicly available due to privacy concerns, but are available from the corresponding author upon reasonable request. Code availability: Not applicable. Authors’ contributions: Conception and design: F. Lo Prinzi, A. Casadei-Gardini, M. Rimini. Acquisition of data (acquired and managed patients): All authors. Analysis and interpretation of data: F. Lo Prinzi, A. Casadei-Gardini. Writing, review, and/or revision of the manuscript: F. Lo Prinzi, A. Casadei-Gardini, M. Rimini. Final approval of manuscript: All authors.

References

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