Comparative Effectiveness of Atezolizumab Plus Bevacizumab Versus Tremelimumab Plus Durvalumab in Patients with Hepatocellular Carcinoma (HCC) in a Real-World Setting.
Federica Lo Prinzi, Federico Rossari, Marianna Silletta, Silvia Camera, Silvia Foti, Mara Persano, Francesco Vitiello, Emanuela Di Giacomo, Mariam Grazia Polito, Margherita Rimini, Andrea Casadei-Gardini
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引用次数: 0
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.
背景:目前还没有研究直接比较atezolizumab + bevacizumab和tremelimumab + durvalumab (STRIDE)这两种用于晚期肝癌(HCC)全身治疗的一线方案。目的:对两种治疗方案的临床疗效进行回顾性分析。患者和方法:使用TriNetX对巴塞罗那临床肝癌(BCLC) B期或C期HCC患者的数据,分析包括使用atezolizumab加贝伐单抗或STRIDE方案治疗的患者。主要终点是比较两个治疗组的总生存期(OS)。结果:在应用倾向评分匹配之前,共确定了2307例连续患者。其中,1998人接受阿特唑单抗联合贝伐单抗治疗,309人接受STRIDE治疗。配对后,剩下618名患者,每组309名。分析显示两种治疗之间无显著差异:atezolizumab + bevacizumab与STRIDE治疗的患者中位OS分别为15.4个月(95%可信区间(CI) 14.7-51.6)和15.5个月(95% CI 15.0-47.0) (HR 0.94;95% CI 0.73-1.22, p = 0.67)。基线临床和实验室特征的单变量分析表明,两种方案之间唯一的区别因素是阿特唑单抗加贝伐单抗的女性生存率更高(HR 1.77;95% CI 1.00-3.16, p = 0.04)。结论:Atezolizumab联合贝伐单抗和STRIDE在OS方面无统计学差异,表明它们对于晚期HCC患者同样有效。
期刊介绍:
Targeted Oncology addresses physicians and scientists committed to oncology and cancer research by providing a programme of articles on molecularly targeted pharmacotherapy in oncology. The journal includes:
Original Research Articles on all aspects of molecularly targeted agents for the treatment of cancer, including immune checkpoint inhibitors and related approaches.
Comprehensive narrative Review Articles and shorter Leading Articles discussing relevant clinically established as well as emerging agents and pathways.
Current Opinion articles that place interesting areas in perspective.
Therapy in Practice articles that provide a guide to the optimum management of a condition and highlight practical, clinically relevant considerations and recommendations.
Systematic Reviews that use explicit, systematic methods as outlined by the PRISMA statement.
Adis Drug Reviews of the properties and place in therapy of both newer and established targeted drugs in oncology.