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Summary

Background

Atezolizumab-bevacizumab (atezo-bev) is recommended as first-line therapy for patients with unresectable hepatocellular carcinoma (uHCC). However, its effectiveness and safety in other populations, including those with Child-Turcotte-Pugh (CTP) class B cirrhosis, is unclear.

Methods

For this systematic review and meta-analysis, electronic databases, including PubMed, Embase, and Scopus, were searched from 1st May, till 5th October, ; the last date of access was January 31, Pooled progression-free survival (PFS), overall survival (OS), and radiological response rate among patients receiving atezo-bev were compared between patients with CTP-A and CTP-B cirrhosis, with tyrosine kinase inhibitors (TKIs) and among those receiving the drug as first-line and later line therapy. The protocol was registered in Prospero (CRD).

Findings

Among 47 studies (n =  patients), pooled PFS and OS were (95% CI, –) and months (95% CI, –), respectively. Objective response rate (ORR) and disease control rate were % (–) and % (–) using RECIST criteria, and 34% (–) and % (–78) using mRECIST criteria, respectively. Among those receiving atezo-bev, patients with CTP-B cirrhosis had similar ORRs by RECIST (odds ratio [OR], [–]; P = ) and mRECIST criteria (OR, [–]; P = ) but shorte

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Abstract

Background

Atezolizumab-bevacizumab (atezo/bev) combination is a recommended first-line systemic therapy for unresectable hepatocellular carcinoma (uHCC). There are no studies from India reporting the safety and efficacy of this drug in real-world settings where most patients present in an advanced stage.

Methods

In this retrospective study from two centers in India, we included patients with uHCC who received atezo/bev as first-line systemic therapy. Comparison of overall survival (OS) among the different Child–Turcotte–Pugh (CTP) classes was the primary objective, while progression-free survival (PFS), radiologic response, and adverse events to the therapy were secondary objectives.

Results

The median age of the 67 patients who received atezo/bev therapy was 61 (29–82) years, and 86% were males. Nonalcoholic steatohepatitis (%) was the commonest cause of cirrhosis, and most patients belonged to BCLC-C (%%). There were 24 patients in CTP A, 36 in CTP B, and 7 in CTP C. The median OS was 12 (95%CI, –) months in the cohort. The median OS in CTP class A, B, and C was 21 (95%CI, 0–) months, 9 (95%CI, –) months, and 4 (95%CI, –) months, respectively (P < ). The median PFS in the whole cohort was 8 (95%CI, –) months. The median PFS in Child A, B, and C was 18 (9

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