Patients with advanced hepatocellular carcinoma treated with atezolizumab plus bevacizumab dual therapy reported improved quality of life, functioning, and disease symptoms. These findings, from an open-label, randomized, phase 3 trial were published in Lancet Oncology.
As patient-reported outcomes have been associated with improved overall survival, the goal of the IMbrave150 trial (ClinicalTrials.gov Identifier: NCT03434379) was to evaluate patient perspectives when treated with dual or monotherapy.
Patients with advanced metastatic or unresectable hepatocellular carcinoma were recruited from 111 centers in 17 countries between 2018 and 2019, and randomly assigned in a 2:1 ratio: 336 participants received 1200 mg atezolizumab and 15 mg/kg bevacizumab intravenously every 3 weeks (dual therapy group) and 165 participants received 400 mg oral sorafenib twice daily (monotherapy group). Patients were surveyed about their quality of life and symptoms.
The dual therapy group had reduced risk for emotional (hazard ratio [HR], 0.47; 95% CI, 0.31-0.71), cognitive (HR, 0.56; 95% CI, 0.40-0.79), or social (HR, 0.71; 95% CI, 0.51-0.98) deterioration and for symptoms of diarrhea (HR, 0.23; 95% CI, 0.16-0.34), nausea and vomiting (0.39; 95% CI, 0.26-0.60), pain (HR, 0.46; 95% CI, 0.34-0.62), dyspnea (HR, 0.54; 95% CI, 0.37-0.79), appetite loss (HR, 0.57; 95% CI, 0.40-0.81), fatigue (HR, 0.61; 95% CI, 0.46-0.81), and insomnia (HR, 0.67; 95% CI, 0.46-0.99).
Greater improvements, compared to baseline, in quality of life, physical functioning, and role of functioning associated with decreased risk for progression (HRs, 0.93; 0.91; 0.89, respectively) and mortality (HRs, 0.70; 0.70; 0.78, respectively).
The HRs in this study should be considered as descriptive as no statistical testing was performed.
These data indicated dual therapy of atezolizumab plus bevacizumab associated with improved quality of life, functioning, and disease symptoms among patients with advanced hepatocellular carcinoma. Improved symptoms were associated with decreased risk for progression and mortality.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Galle PR, Finn RS, Qin S, et al. Patient-reported outcomes with atezolizumab plus bevacizumab versus sorafenib in patients with unresectable hepatocellular carcinoma (IMbrave150): an open-label, randomised, phase 3 trial. Lancet Oncol. Published online May 27, 2021. doi:10.1016/S1470-2045(21)00151-0