New treatments for unresectable hepatocellular carcinoma (HCC) were approved based on a Phase 3 clinical trial. Richard Kim has recently provided an overview of this study.
This study ultimately led to the approval of bevacizumab and atezolizumab. The randomized trial was called IMbrave150. This study included a control group (sorafenib) as well as a group for the combination treatment of bevacizumab and atezolizumab.
The primary endpoints of this trial were overall survival and progression-free survival. Follow-up data on overall survival was presented at the American Society of Clinical Oncology Gastrointestinal Cancers Symposium this year.
This trial demonstrated that the new combination treatment was far superior to the sorafenib when examining response rate. Progression-free survival also improved by 2 months. The follow-up overall survival data demonstrated that patients survived 19 months with the combination therapy. For sorafenib, it was just 13-14 months.
Dr. Kim explains that 19 months of survival for patients with advanced HCC is the longest ever demonstrated.
Further, adverse events were not very different between the two treatment groups. Hypertension was a bit more common in the combination treatment group, and hand-food-skin reactions were a bit more common with the sorafenib group. However, overall both treatments were very well tolerated.
Adverse events that were grade 3 or grade 4 were very rare. Most were grade 1 and grade 2. Further, the grade 3/4 event of hypertension was very well managed.
As a result of the IMbrave150 study, this combination treatment was FDA approved. It is now also in the National Comprehensive Cancer Network guidelines.
Dr. Kim also speaks from personal experience that in his clinic, the treatment has been life-changing for patients. He also explains that he utilizes endoscopies to ensure there is no unwanted bleeding.
You can read the full details on this treatment and how Dr. Kim has altered his practice during the age of COVID-19 here.