Introduction: Atezolizumab-bevacizumab is the new standard of care for first-line treatment of advanced hepatocellular carcinoma (HCC). However, the optimal sequence of therapy after disease progression on atezolizumab-bevacizumab is unclear. Methods: This multinational, multicenter, and retrospective study assessed clinical outcomes of patients with advanced HCC who received subsequent systemic therapy after progression on atezolizumab-bevacizumab between July 2016 and April 2019. Results: Among 71 patients treated with atezolizumab-bevacizumab, a total of 49 patients who received subsequent systemic therapy were included in this analysis; the median age was 60 years (range, 37–80) and 73.5% were male. All patients were classified as Child-Pugh A and Barcelona-Clinic Liver Cancer stage C. Multikinase inhibitors (MKIs), including sorafenib (n = 29), lenvatinib (n = 19), and cabozantinib (n = 1), were used as second-line therapy for all patients. The objective response rate and disease control rate were 6.1 and 63.3%, respectively, in all patients. With a median follow-up duration of 11.0 months, median progression-free survival (PFS) and overall survival (OS) were 3.4 months (95% confidence interval [CI] 1.8–4.9) and 14.7 months (95% CI 8.1–21.2) in all patients. Median PFS with lenvatinib was significantly longer than that with sorafenib (6.1 vs. 2.5 months; p = 0.004), although there was no significant difference in median OS (16.6 vs. 11.2 months; p = 0.347). Treatment-related adverse events (TRAEs) of any grade and grade 3 occurred in 42 (85.7) and 8 (16.3%) of patients. Common TRAEs included hand-foot syndrome (n = 26, 53.1%), fatigue (n = 14, 28.6%), hypertension (n = 14, 28.6%), and diarrhea (n = 12, 24.5%). Conclusion: Second-line treatment with MKIs, mostly sorafenib and lenvatinib, showed comparable efficacy and manageable toxicities in patients with advanced HCC after disease progression on atezolizumab-bevacizumab.
Liver Cancer

中文翻译：

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一线Atezolizumab加Bevacizumab治疗晚期肝细胞癌后多激酶抑制剂的临床疗效：多国多中心回顾性研究

简介： Atezolizumab-bevacizumab是晚期肝细胞癌（HCC）一线治疗的新治疗标准。然而，在疾病进展后在阿特珠单抗-贝伐单抗上的最佳治疗顺序尚不清楚。方法：这种跨国，多中心，以及回顾性研究评估了患者的晚期肝癌谁收到后续的全身治疗进展后atezolizumab，贝伐单抗2016年7月和2019年四月的临床结局结果：该分析包括71例接受atezolizumab-bevacizumab治疗的患者，总共49例接受后续全身治疗的患者。中位年龄为60岁（范围37-80），男性为73.5％。所有患者均被归类为Child-Pugh A和C期巴塞罗那临床肝癌。多激酶抑制剂（MKI），包括索拉非尼（n = 29），lenvatinib（n = 19）和cabo​​zantinib（n= 1），用作所有患者的二线治疗。所有患者的客观缓解率和疾病控制率分别为6.1％和63.3％。中位随访时间为11.0个月，中位无进展生存期（PFS）和总体生存期（OS）分别为3.4个月（95％置信区间[CI]为1.8-4.9）和14.7个月（95％CI为8.1-21.2） ）在所有患者中。lenvatinib的中位PFS明显长于sorafenib的中位（6.1 vs. 2.5个月；p = 0.004），尽管中位OS并无显着差异（16.6 vs. 11.2个月；p = 0.347）。分别在42（85.7）和8（16.3％）位患者中发生任何级别和3级的治疗相关不良事件（TRAE）。常见的TRAE包括手足综合征（n = 26，53.1 ％），疲劳（n = 14、28.6％），高血压（n = 14、28.6％）和腹泻（n = 12、24.5％）。结论：在阿特唑单抗-贝伐单抗治疗后，MKI的二线治疗（主要是索拉非尼和lenvatinib）在疾病进展后的晚期HCC患者中显示出可比的疗效和可控制的毒性。
肝癌