IMbrave 150
Trial question
What is the effect of atezolizumab plus bevacizumab in patients with unresectable HCC?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
17.0% female
83.0% male
N = 501
501 patients (87 female, 414 male).
Inclusion criteria: patients with unresectable HCC who had not previously received systemic treatment.
Key exclusion criteria: history of autoimmune disease; coinfection with HBV or HCV; untreated or incompletely treated esophageal or gastric varices with bleeding or high risk of bleeding.
Interventions
N=336 atezolizumab-bevacizumab (intravenous administration of 1,200 mg and 15 mg/kg, respectively, on day 1 of each 21-day cycle).
N=165 sorafenib (at a dose of 400 mg BID, on days 1-21 of each 21-day cycle).
Primary outcome
Overall survival at 12 months
67.2%
54.6%
67.2 %
50.4 %
33.6 %
16.8 %
0.0 %
Atezolizumab-bevacizumab
Sorafenib
Significant
increase ▲
NNT = 7
Significant increase in overall survival at 12 months (67.2% vs. 54.6%; AD 12.6%, 95% CI 5.12 to 20.08).
Secondary outcomes
Significant increase in median progression-free survival (6.8 months vs. 4.3 months; AD 2.5 months, 95% CI 1.02 to 3.98).
Significant increase in confirmed objective response (27.3% vs. 11.9%; AD 15.4%, 95% CI 6.26 to 24.54).
Safety outcomes
No significant differences in adverse events, grade 3 or 4 adverse events.
Conclusion
In patients with unresectable HCC who had not previously received systemic treatment, atezolizumab-bevacizumab was superior to sorafenib with respect to overall survival at 12 months.
Reference
Richard S Finn, Shukui Qin, Masafumi Ikeda et al. Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma. N Engl J Med. 2020 May 14;382(20):1894-1905.
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