Objective: This study aimed to evaluate the characteristics, clinical outcomes, and resource use of patients with unresectable hepatocellular carcinoma (uHCC) treated with first-line (1L) atezolizumab plus bevacizumab (A+B) at five United States (US) institutions: the Mayo Clinic, Houston Methodist, Moffitt Cancer Center, Mays Cancer Center, and University of Arizona.Methods: Treating oncologists extracted data from medical charts of patients with uHCC who were treated with A+B after 1 January 2019. Real-world progression-free survival (rwPFS) and overall survival (OS) were assessed using the Kaplan–Meier method for the overall cohort and for a “trial-like” subgroup with characteristics similar to those in the IMbrave150 trial (Eastern Cooperative Oncology Group Performance Status [ECOG PS] 0–1, Child–Pugh [CP] class A, albumin–bilirubin grade 1–2).Results: Of the 300 patients in the overall cohort (median age of 68 years; 12% ECOG PS ≥ 2; 73% CP A; 26% CP B; median follow-up of 8.7 months), the median rwPFS was 6.8 (95% confidence interval [CI]: 5.8, 8.4) months, and the median OS was 14.4 (95% CI: 12.3, 18.2) months. In the trial-like subgroup (n= 194), the median rwPFS was 8.8 (95% CI: 7.6, 12.1) months and the median OS was 19.5 (95% CI: 14.6, 24.7) months. A significantly lower proportion of patients with CP A compared with CP B (39.7% vs. 73.4%) experienced hospitalization within one year of A+B initiation, whereas hospitalizations due to treatment-related adverse events were similar.Conclusions: This study provides insights into the real-world effectiveness of 1L A+B in a diverse US patient cohort, with results from trial-like patients supporting the reproducible efficacy of A+B in clinical practice.
目的：本研究旨在评估美国五家医疗机构（梅奥诊所、休斯顿卫理公会医院、莫菲特癌症中心、梅斯癌症中心及亚利桑那大学）中接受一线阿替利珠单抗联合贝伐珠单抗（A+B）治疗的不可切除肝细胞癌（uHCC）患者的临床特征、治疗结局及医疗资源使用情况。 方法：治疗肿瘤科医师提取了2019年1月1日后接受A+B治疗的uHCC患者的病历资料。采用Kaplan-Meier法评估整体队列及符合IMbrave150试验入组标准的“类试验”亚组（东部肿瘤协作组体能状态[ECOG PS] 0-1分、Child-Pugh [CP] A级、白蛋白-胆红素分级1-2级）患者的真实世界无进展生存期（rwPFS）和总生存期（OS）。 结果：在整体队列的300例患者中（中位年龄68岁；ECOG PS≥2分者占12%；CP A级占73%；CP B级占26%；中位随访时间8.7个月），中位rwPFS为6.8个月（95%置信区间[CI]：5.8, 8.4），中位OS为14.4个月（95% CI：12.3, 18.2）。在类试验亚组（n=194）中，中位rwPFS为8.8个月（95% CI：7.6, 12.1），中位OS为19.5个月（95% CI：14.6, 24.7）。CP A级患者在A+B治疗启动后一年内住院比例显著低于CP B级患者（39.7% vs. 73.4%），而治疗相关不良事件导致的住院率在两组间相近。 结论：本研究揭示了A+B一线治疗在美国多样化uHCC患者群体中的真实世界疗效，类试验亚组的结果支持A+B在临床实践中具有可重复的有效性。
肿瘤(癌症)患者之家