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Multicenter Study
. 2025 Jul 1;25(1):1026.
doi: 10.1186/s12885-025-14400-9.

Safety and efficacy of atezolizumab/bevacizumab in unresectable hepatocellular carcinoma-a multicentric study

Merin Babu  1 , Ashok Sebastian Komaranchath  2 , Arun Valsan  3 , Arun R Warrier  2 , Rakesh Mp  1 , Wesley M Jose  1 , Nikhil K Haridas  1 , Sumi Soman  1 , Manjima P Nair  3 , Shine Sadasivan  4 , Abhinav Menon  2 , Mohammed Thabrez  2 , Keechilat Pavithran  5
Affiliations
Multicenter Study

Safety and efficacy of atezolizumab/bevacizumab in unresectable hepatocellular carcinoma-a multicentric study

Merin Babu et al. BMC Cancer. .

Abstract

Purpose: Immunotherapy with atezolizumab and bevacizumab is the current first-line standard of care for unresectable hepatocellular carcinoma (HCC). This study aimed to evaluate the safety and efficacy profile of atezolizumab-bevacizumab in the Indian population, as there are limited studies.

Patients and methods: All patients diagnosed with advanced HCC who received systemic therapy with atezolizumab bevacizumab as the first- or second-line therapy were included in the study. Data were collected retrospectively from two comprehensive cancer centres between September 2020 and May 2024 by accessing the medical records. As per the IMBrave 150 trial, patients were given atezolizumab 1200 mg and bevacizumab 15 mg/kg intravenously every 3 weeks. Demographic details, adverse events, and radiological data were collected.

Results: We included one hundred and four patients with a median age of 67 years. Majority of the patients had a compensated cirrhosis (n = 77; 74%), while Child Pugh class B cirrhosis was observed in 19 patients (18%), and class C cirrhosis in 3 patients (3%). The median OS was 14.8 (95% CI; 6.8 - 22.9) months and median PFS in the whole cohort was 6.2 months (95% CI; 2.5 - 9.9) monthsGlobally, hepatocellular carcinoma (HCC) ranks sixth in incidence and third among cancer-related dea.

Conclusion: The real-world OS and PFS rates were lower than those of the IMBrave trial, most likely because 43% of our patients did not meet the inclusion criteria. We conclude that the combination of atezolizumab and bevacizumab is a safe and effective option for patients with unresectable hepatocellular carcinoma patients with manageable toxicities.

Keywords: atezolizumab; bevacizumab; hepatocellular carcinoma; immune checkpoint inhibitors; real world.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the Institutional Ethics Committee of Amrita School of Medicine (IEC-AIMS-2024-ONCO-177) on 13-08-2024 and was conducted as per principles of the Declaration of Helsinki and guidelines of the Indian Council of Medical Research. All the authors certify that they have obtained all appropriate patient consent for the study. Consent for publication: All authors have read and agreed to the published version of the manuscript. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan-Meir curve depicting the overall survival (A); survival according to Child Pugh status (B); survival according to ALBI grade (C); survival according to age group (D)
Fig. 2
Fig. 2
Kaplan-Meir curve depicting the progression free survival (A); progression free survival according to Child Pugh status (B); progression free survival according to ALBI grade (C); progression free survival according to age group (D)
See this image and copyright information in PMC

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