Daniel H. Ahn, DO, discusses the utility of atezolizumab in combination with bevacizumab in hepatocellular carcinoma.
Daniel H. Ahn, DO, an oncologist, internist, and assistant professor of medicine at Mayo Clinic, discusses the utility of atezolizumab (Tecentriq) in combination with bevacizumab (Avastin) in hepatocellular carcinoma (HCC).
The majority of patients with unresectable HCC who are ineligible for liver transplantation should receive systemic atezolizumab/bevacizumab as frontline therapy unless they have contraindications, says Ahn. For example, patients with immune-related comorbidities, such as autoimmune diseases or significant toxicity with prior checkpoint inhibitors, or who are ineligible for antiangiogenic therapies, may not be eligible to receive the up-front combination, Ahn explains.
Patients receiving atezolizumab/bevacizumab should be screened and appropriately treated for esophageal varices to reduce the risk of bleeding associated with the combination, says Ahn. In patients who were properly managed, the risk of bleeding was minimal with the combination and was just slightly higher compared with the risk associated with sorafenib (Nexavar), concludes Ahn.