Background/Objectives:This study evaluated comparative overall survival (OS) of United States veterans with unresectable hepatocellular carcinoma (uHCC) receiving first-line (1L) atezolizumab plus bevacizumab vs. sorafenib or lenvatinib, overall and across racial and ethnic groups.Methods:In this retrospective study, patients with uHCC who initiated atezolizumab plus bevacizumab (post-2020) or sorafenib or lenvatinib (post-2018) were identified from the Veterans Health Administration National Corporate Data Warehouse (1 January 2017–31 December 2022). Patient characteristics were evaluated in the year prior to 1L treatment initiation. Kaplan–Meier and multivariable Cox regression methods were used to compare OS starting from treatment between cohorts, both overall and by race and ethnicity.Results:Among the 1874 patients included, 405 (21.6%) received 1L atezolizumab plus bevacizumab, 1016 (54.2%) received sorafenib, and 453 (24.2%) received lenvatinib, with a median follow-up time of 8.5, 7.6, and 8.2 months, respectively. Overall, patients receiving atezolizumab plus bevacizumab had longer unadjusted median OS (12.8 [95% CI: 10.6, 17.1] months) than patients receiving sorafenib (8.0 [7.1, 8.6] months) or lenvatinib (9.5 [7.8, 11.4] months; both log-rankp< 0.001). After adjustment, atezolizumab plus bevacizumab was associated with a reduced risk of death by 30% vs. sorafenib (adjusted HR: 0.70 [95% CI: 0.60, 0.82]) and by 26% vs. lenvatinib (0.74 [0.62, 0.88]; bothp< 0.001). OS trends in the White, Black, and Hispanic patient cohorts were consistent with that of the overall population.Conclusions:Atezolizumab plus bevacizumab was associated with improved survival outcomes compared with sorafenib and lenvatinib in patients with uHCC, both overall and across racial and ethnic subgroups.
背景/目的：本研究评估了美国退伍军人中不可切除肝细胞癌（uHCC）患者接受一线（1L）阿替利珠单抗联合贝伐珠单抗对比索拉非尼或仑伐替尼治疗的总生存期（OS），并在总体及各种族和族裔亚组中进行比较。 方法：在这项回顾性研究中，从退伍军人健康管理局国家企业数据仓库（2017年1月1日至2022年12月31日）中识别出开始接受阿替利珠单抗联合贝伐珠单抗（2020年后）或索拉非尼或仑伐替尼（2018年后）治疗的uHCC患者。在开始1L治疗前一年评估患者特征。采用Kaplan-Meier法和多变量Cox回归模型比较各队列从治疗开始起的OS，包括总体分析及按种族和族裔分层分析。 结果：在纳入的1874例患者中，405例（21.6%）接受1L阿替利珠单抗联合贝伐珠单抗治疗，1016例（54.2%）接受索拉非尼治疗，453例（24.2%）接受仑伐替尼治疗，中位随访时间分别为8.5、7.6和8.2个月。总体而言，接受阿替利珠单抗联合贝伐珠单抗治疗的患者未调整中位OS（12.8 [95% CI: 10.6, 17.1]个月）长于接受索拉非尼（8.0 [7.1, 8.6]个月）或仑伐替尼（9.5 [7.8, 11.4]个月）治疗的患者（对数秩检验p值均<0.001）。调整后，与索拉非尼相比，阿替利珠单抗联合贝伐珠单抗治疗使死亡风险降低30%（调整后HR: 0.70 [95% CI: 0.60, 0.82]）；与仑伐替尼相比，死亡风险降低26%（0.74 [0.62, 0.88]；p值均<0.001）。白人、黑人和西班牙裔患者队列的OS趋势与总体人群一致。 结论：在uHCC患者中，无论是总体人群还是不同种族和族裔亚组，阿替利珠单抗联合贝伐珠单抗治疗相比索拉非尼和仑伐替尼均显示出更优的生存结局。
肿瘤(癌症)患者之家