IMbrave150:Atezolizumab联合贝伐单抗与索拉非尼治疗巴塞罗那临床癌症B期不可切除肝癌患者的疗效和安全性:III期研究的探索性分析。

IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Liver Cancer Pub Date : 2022-11-28 eCollection Date: 2023-08-01 DOI:10.1159/000528272
Masatoshi Kudo, Richard S Finn, Peter R Galle, Andrew X Zhu, Michel Ducreux, Ann-Lii Cheng, Masafumi Ikeda, Kaoru Tsuchiya, Ken-Ichi Aoki, Jing Jia, Riccardo Lencioni
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引用次数: 7

摘要

引言:IMbrave150 III期研究确定atezolizumab+bevacizumab为不可切除肝细胞癌(HCC)患者的标准护理。这项探索性分析报告了基线巴塞罗那临床癌症(BCLC)B期疾病患者的疗效和安全性结果。方法:将系统治疗初期不可切除HCC和Child-Pugh A级肝功能的患者以2:1随机分组,接受1200 mg atezolizumab加15 mg/kg贝伐单抗或400 mg索拉非尼治疗。共同的主要终点是BCLC B期亚组中每个独立审查机构(IRF)评估的实体瘤反应评估标准(RECIST)1.1版的总生存期(OS)和无进展生存期(PFS)。根据电子病例报告表,该分析中的患者在基线时患有BCLC B期疾病。次要疗效终点包括根据IRF RECIST 1.1和改良RECIST(mRECIST)治疗HCC的客观有效率(ORR)和目标病变自基线以来最长直径之和(SLD)的变化。结果:在501名入选患者中,74人(15%)在基线时患有BCLC B期疾病(atezolizumab+bevacizumab,n=49;索拉非尼,n=24)。该组的中位随访时间为19.7个月。与索拉非尼相比,atezolizumab+bevacizumab在IRF RECIST 1.1中观察到OS和PFS改善的趋势(OS:危险比[HR]:0.63;95%置信区间[CI]:0.29,1.34;PFS:HR:0.64;95%CI:0.36,1.12)。根据IRF RECIST 1.1和HCC mRECIST,靶病变的SLD与基线相比的百分比变化显示,atezolizumab+贝伐单抗治疗具有持久的疗效。在整个研究人群中,安全性数据与atezolizumab和贝伐单抗的已知情况一致。讨论/结论:atezolizumab+bevacizumab在基线BCLC B期疾病患者中观察到疗效益处,与治疗人群的意向一致。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

IMbrave150: Efficacy and Safety of Atezolizumab plus Bevacizumab versus Sorafenib in Patients with Barcelona Clinic Liver Cancer Stage B Unresectable Hepatocellular Carcinoma: An Exploratory Analysis of the Phase III Study.

IMbrave150: Efficacy and Safety of Atezolizumab plus Bevacizumab versus Sorafenib in Patients with Barcelona Clinic Liver Cancer Stage B Unresectable Hepatocellular Carcinoma: An Exploratory Analysis of the Phase III Study.

IMbrave150: Efficacy and Safety of Atezolizumab plus Bevacizumab versus Sorafenib in Patients with Barcelona Clinic Liver Cancer Stage B Unresectable Hepatocellular Carcinoma: An Exploratory Analysis of the Phase III Study.

IMbrave150: Efficacy and Safety of Atezolizumab plus Bevacizumab versus Sorafenib in Patients with Barcelona Clinic Liver Cancer Stage B Unresectable Hepatocellular Carcinoma: An Exploratory Analysis of the Phase III Study.

Introduction: The phase III IMbrave150 study established atezolizumab + bevacizumab as standard of care in patients with unresectable hepatocellular carcinoma (HCC). This exploratory analysis reports efficacy and safety results in patients with baseline Barcelona Clinic Liver Cancer (BCLC) stage B disease.

Methods: Patients with systemic treatment-naive unresectable HCC and Child-Pugh class A liver function were randomized 2:1 to receive 1,200 mg of atezolizumab plus 15 mg/kg of bevacizumab or 400 mg of sorafenib. Co-primary endpoints were overall survival (OS) and progression-free survival (PFS) per independent review facility (IRF)-assessed Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1 in the BCLC stage B subgroup. Patients in this analysis had BCLC stage B disease at baseline per electronic case report form. Secondary efficacy endpoints included the objective response rate (ORR) and change in the sum of longest diameters (SLD) of target lesions from baseline per IRF RECIST 1.1 and modified RECIST (mRECIST) for HCC.

Results: Of 501 enrolled patients, 74 (15%) had BCLC stage B disease at baseline (atezolizumab + bevacizumab, n = 49; sorafenib, n = 24). For this group, median follow-up was 19.7 months. A trend toward improved OS and PFS per IRF RECIST 1.1 was observed with atezolizumab + bevacizumab versus sorafenib (OS: hazard ratio [HR]: 0.63; 95% confidence interval [CI]: 0.29, 1.34; PFS: HR: 0.64; 95% CI: 0.36, 1.12). ORRs per IRF RECIST 1.1 and HCC mRECIST were 43% and 50% with atezolizumab + bevacizumab and 26% and 30% with sorafenib, respectively. Percentage change in SLD of target lesions from baseline per IRF RECIST 1.1 and HCC mRECIST showed durable responses with atezolizumab + bevacizumab treatment. Safety data were consistent with known profiles of atezolizumab and bevacizumab, as seen in the overall study population.

Discussion/conclusion: Efficacy benefits were observed with atezolizumab + bevacizumab in patients with baseline BCLC stage B disease, consistent with the intention-to-treat population.

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来源期刊
Liver Cancer
Liver Cancer Medicine-Oncology
CiteScore
20.80
自引率
7.20%
发文量
53
审稿时长
16 weeks
期刊介绍: Liver Cancer is a journal that serves the international community of researchers and clinicians by providing a platform for research results related to the causes, mechanisms, and therapy of liver cancer. It focuses on molecular carcinogenesis, prevention, surveillance, diagnosis, and treatment, including molecular targeted therapy. The journal publishes clinical and translational research in the field of liver cancer in both humans and experimental models. It publishes original and review articles and has an Impact Factor of 13.8. The journal is indexed and abstracted in various platforms including PubMed, PubMed Central, Web of Science, Science Citation Index, Science Citation Index Expanded, Google Scholar, DOAJ, Chemical Abstracts Service, Scopus, Embase, Pathway Studio, and WorldCat.
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