Efficacy of the Atezolizumab-bevacizumab regimen as first-line treatment for unresectable hepatocellular carcinoma
Main Article Content
Abstract
Hepatocellular carcinoma is a common malignancy with many treatment opportunities in advanced stages in recent years. The Atezolizumab-Bevacizumab regimen has also been approved by the FDA and has been used in Vietnam since 2020. We conducted a descriptive, combined retrospective and prospective study on 115 HCC patients at Hanoi Oncology Hospital, Bach Mai Hospital, and K Hospital from May 2020 to August 2024. Results showed the objective response rate was 27.7%; the disease control rate (DCR) was 67.8%. Factors influencing DCR included ECOG, Child-Pugh classification, AFP concentration, liver tumor location, type of portal vein thrombosis and distant metastasis status. Thus, the Atezolizumab-Bevacizumab regimen as first-line treatment for patients with hepatocellular carcinoma who are unresectable has a high response rate and disease control rate in clinical practice.
Article Details
Keywords
Hepatocellular carcinoma, Atezolizumab-Bevacizumab, first-line, response rate, disease control rate
References
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20. Song BG, Goh MJ, Kang W, et al. Analysis of Factors Predicting the Real-World Efficacy of Atezolizumab and Bevacizumab in Patients with Advanced Hepatocellular Carcinoma. Gut Liver. 2024; 18(4): 709-718. doi:10.5009/gnl240085.
2. Liu X, Lu Y, Qin S. Atezolizumab and bevacizumab for hepatocellular carcinoma: mechanism, pharmacokinetics and future treatment strategies. Future Oncol. 2021; 17(17): 2243-2256. doi:10.2217/fon-2020-1290.
3. Zhao J, Zhang Y, Qin S, et al. Hepatitis B Virus Reactivation in Cancer Patients Undergoing Immune Checkpoint Inhibitors Therapy: A Systematic Review. J Cancer. 2022; 13(14): 3539-3553. doi:10.7150/jca.77247.
4. Espinoza M, Muquith M, Lim M, et al. Disease Etiology and Outcomes After Atezolizumab Plus Bevacizumab in Hepatocellular Carcinoma: Post-Hoc Analysis of IMbrave150. Gastroenterology. 2023; 165(1): 286-288.e4. doi:10.1053/j.gastro.2023.02.042.
5. Brown TJ, Mamtani R, Gimotty PA, et al. Outcomes of hepatocellular carcinoma by etiology with first-line atezolizumab and bevacizumab: a real-world analysis. J Cancer Res Clin Oncol. 2023; 149(6): 2345-2354. doi:10.1007/s00432-023-04590-9.
6. Kulkarni A, Krishna V, Kumar K, et al. Safety and Efficacy of Atezolizumab-Bevacizumab In Real-World -The First Indian Experience. J Clin Exp Hepatol. 2023; 13. doi:10.1016/j.jceh.2023.02.003.
7. Shao M, Tan B, Fan C, et al. Effectiveness and Safety of Atezolizumab Plus Bevacizumab in Unresectable Hepatocellular Carcinoma: A Multicenter, Retrospective Real-World Study in China. Clin Med Insights Oncol. 2026; 20. doi:10.1177/11795549251414656.
8. Kulkarni AV, Tevethia H, Kumar K, et al. Effectiveness and safety of atezolizumab-bevacizumab in patients with unresectable hepatocellular carcinoma: a systematic review and meta-analysis. eClinicalMedicine. 2023; 63: 102179. doi:10.1016/j.eclinm.2023.102179.
9. Gairing SJ, Mildenberger P, Gile J, et al. Evaluation of prognostic scores in patients with HCC undergoing first-line immunotherapy with atezolizumab and bevacizumab. JHEP Rep. 2024; 7(3): 101295. doi:10.1016/j.jhepr.2024.101295.
10. Claudia Campani, Dimitrios Pallas, Sabrina Sidali, et al. Heterogeneity in adverse events related to atezolizumab-bevacizumab for hepatocellular carcinoma reported in real-world studies. JHEP Rep. 2024 Aug 22; 6(11): 101190. doi: 10.1016/j.jhepr.2024.101190.
11. Allaire M, Thiam EM, Amaddeo G, et al. Real-World Outcomes of Atezolizumab-Bevacizumab in Hepatocellular Carcinoma: The Prospective French CHIEF Cohort. Liver Int Off J Int Assoc Study Liver. 2025; 45(10): e70337. doi:10.1111/liv.70337.
12. Kournoutas I, Marell P, Gile J, et al. First-line atezolizumab/bevacizumab or durvalumab/tremelimumab in advanced hepatocellular carcinoma: a real world, multicenter retrospective study. The Oncologist. 2025; 30(11): oyaf286. doi:10.1093/oncolo/oyaf286.
13. Biomarkers and prognostic factors of PD-1/PD-L1 inhibitor-based therapy in patients with advanced hepatocellular carcinoma - PMC. Accessed January 30, 2026. https://pmc.ncbi.nlm.nih.gov/articles/PMC10865587/.
14. Wang X, Chen S, Yu W, et al. A Retrospective Study of Hepatic Arterial Infusion Chemotherapy Combined with Tyrosine Kinase Inhibitors and PD-1 Inhibitors in Hepatocellular Carcinoma Patients with Main Portal Vein Tumor Thrombus (VP4). J Hepatocell Carcinoma. 2026; Volume 13:1-14. doi:10.2147/JHC.S562766.
15. Huang D, Ke L, Cui H, et al. Efficacy and safety of PD-1/PD-L1 inhibitors combined with anti-angiogenic therapy for the unresectable hepatocellular carcinoma and the benefit for hepatitis B virus etiology subgroup: a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2023; 23(1): 474. doi:10.1186/s12885-023-10960-w.
16. Ferrando-Martinez S, Snell Bennett A, Lino E, et al. Functional Exhaustion of HBV-Specific CD8 T Cells Impedes PD-L1 Blockade Efficacy in Chronic HBV Infection. Front Immunol. 2021; 12: 648420. doi:10.3389/fimmu.2021.648420.
17. Prognostic Factor Analysis of Atezolizumab-Bevacizumab in Unresectable Hepatocellular Carcinoma: Korean Cancer Study Group Study. Gastroenterol Hepatol. 2021; 17(11 Suppl 6): 17-18.
18. Teng W, Lin CC, Su CW, et al. Combination of CRAFITY score with Alpha-fetoprotein response predicts a favorable outcome of atezolizumab plus bevacizumab for unresectable hepatocellular carcinoma. Am J Cancer Res. 2022; 12(4): 1899-1911.
19. Park J, Lee DH, Hur MH, et al. Prognostic Impact of Varices and Hemorrhagic Events in Hepatocellular Carcinoma Patients Treated with Atezolizumab Plus Bevacizumab. Gut Liver. doi:10.5009/gnl250133.
20. Song BG, Goh MJ, Kang W, et al. Analysis of Factors Predicting the Real-World Efficacy of Atezolizumab and Bevacizumab in Patients with Advanced Hepatocellular Carcinoma. Gut Liver. 2024; 18(4): 709-718. doi:10.5009/gnl240085.