The combination of the anti-programmed death ligand 1 (anti–PD-L1) antibody atezolizumab and bevacizumab significantly delayed time to deterioration in quality of life (QoL) compared with sorafenib in patients with unresectable hepatocellular carcinoma (HCC), according to results of a longitudinal assessment of patient-reported outcomes (PROs) in a phase 3 study. The findings from this analysis were presented at the 2020 Gastrointestinal Cancers Symposium held in San Francisco, California.1

Previously reported results from the phase 3 IMbrave150 study (ClinicalTrials.gov Identifier: NCT03434379) showed “statistically significant and clinically meaningful improvement” in the primary study endpoint of overall survival (OS) for systemic therapy-naive patients with unresectable HCC receiving first-line therapy with atezolizumab and bevacizumab compared with sorafenib alone. 2 Similar rates of grade 3 to 4 and grade 5 adverse events were reported for patients in the 2 treatment arms.

Results of prespecified analyses included secondary study endpoints involving patient-reported time to deterioration, involving a drop of 10 points or more from baseline in QoL, physical functioning, and role functioning as assessed using 2 validated patient-reported outcome (PRO) measures.

In addition, prespecified exploratory study endpoints related to patient-reported time to deterioration of specific symptoms, as well as the proportion of patients experiencing these symptoms, were also evaluated using the same PRO tools, which were completed by patients at baseline, every 3 weeks during treatment, and every 3 months following treatment discontinuation or progression of disease.1

Respective median time to deterioration for patients treated with atezolizumab plus bevacizumab compared with sorafenib were 11.2 months and 3.6 months for QoL (hazard ratio [HR], 0.63; 95% CI, 0.46-0.85), 13.1 months and 4.9 months for physical functioning (HR, 0.53; 95% CI, 0.39-0.73), and 9.1 months and 3.6 months for role functioning (HR, 0.62;95% CI, 0.46-0.84).1

In addition, fewer patients receiving combination therapy experienced clinically meaningful deterioration in specific symptoms, such as appetite loss, fatigue, pain, and diarrhea, and time to deterioration regarding these symptoms was longer for those who were treated with atezolizumab in combination with bevacizumab compared with sorafenib alone.1

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In commenting on the importance of improved QoL in patients with advanced HCC, Peter R. Galle, MD, PhD of the University Medical Center in Mainz, Germany, and the lead author of the study, commented in a press release that “patients with liver cancer are typically more fragile and frail than others. Toxicity of the treatments can be much more serious for these patients, and their quality of life can decline quite quickly.”3

In addition, the study authors noted that “PRO results from IMbrave150 showed large and consistent benefits in key aspects of the patient experience with atezolizumab plus bevacizumab, further supporting its overall clinical benefit in patients with unresectable HCC who have not received prior systemic therapy.”1

Disclosures: This study was funded by F. Hoffmann-La Roche, Ltd. Some of the study authors disclosed financial relationships with pharmaceutical companies. For a full list of disclosures, please refer to the study abstract.

References

  1. Galle PR, Finn RS, Qin S, et al. Patient-reported outcomes (PROs) from the phase III IMbrave150 trial of atezolizumab (atezo) + bevacizumab (bev) vs sorafenib (sor) as first-line treatment (tx) for patients (pts) with unresectable hepatocellular carcinoma (HCC). J Clin Oncol. 2020;38(suppl 4):Abstract 476.
  2. Cheng A-L, Qin S, Ikeda M, et al. IMbrave150: Efficacy and safety results from a phase III study evaluating atezolizumab (atezo) + bevacizumab (bev) vs sorafenib (sor) as first treatment (tx) for patients (pts) with unresectable hepatocellular carcinoma (HCC). Ann Oncol. 2019;30(suppl_9):Abstract LBA3.
  3. Press Release from 2020 Gastrointestinal Cancers Symposium. New drug combinations maintain quality of life for patients with colorectal and liver cancers [press release]. Published January 21, 2019. Accessed January 22, 2020.

This article originally appeared on Cancer Therapy Advisor