Dr Finn on Adding Tiragolumab to Atezolizumab and Bevacizumab in Locally Advanced or Metastatic HCC

“The most striking thing with this [updated] dataset is the overall survival, which is now at 26.6 months for the triplet. The objective response rate and duration of response have been very stable.”

Richard Finn, MD, a professor of medicine at the Geffen School of Medicine in the Department of Medicine, Division of Hematology/Oncology, at UCLA, detailed updated findings from the randomized phase 1/2 MORPHEUS-Liver trial (NCT04524871) evaluating the addition of tiragolumab—a novel anti–TIGIT antibody—to the established combination of atezolizumab (Tecentriq) and bevacizumab (Avastin) in patients with unresectable locally advanced or metastatic hepatocellular carcinoma (HCC).

The updated analysis presented at the 2025 ESMO Gastrointestinal Cancers Congress, demonstrated a median overall survival (OS) of 26.6 months (95% CI, 22.6-40.6) in patients treated with the triplet regimen (n = 40) compared with 16.0 months (95% CI, 7.5-18.5) in those given atezolizumab plus bevacizumab alone (n = 18; HR, 0.55; 95% CI 0.29-1.04). According to Finn, this represents a notable outcome in the current therapeutic landscape, where multiple systemic options are now available for patients with advanced HCC. The objective response rate (ORR) and duration of response (DOR) data remained consistent with earlier reports. Patients treated with the tiragolumab regimen experienced an ORR of 42.5% (95% CI, 27.0%-59.0%) vs 11.1% (95% CI, 1.4%-34.7%) for those given the doublet. Progression-free survival (PFS) was extended to 12.3 months (95% CI, 8.2-17.5) vs 4.2 months (95% CI, 2.3-7.4) for the triplet and doublet, respectively (HR, 0.63; 95% CI, 0.35-1.15).

Finn noted that the findings from this study formed the foundation for the phase IMbrave-152/SKYSCRAPER-14 trial (NCT05904886), an ongoing randomized, placebo-controlled trial assessing the triplet of tiragolumab plus atezolizumab and bevacizumab vs atezolizumab and bevacizumab with placebo. The co-primary end points are OS and PFS. These results are highly anticipated, as they will determine the viability of incorporating tiragolumab into standard first-line treatment for advanced HCC, Finn said.

Finn concluded that the MORPHEUS-Liver study represents one of the first robust datasets to evaluate a triplet immunotherapy regimen built on a bevacizumab-containing backbone in advanced HCC. Given the evolving treatment landscape—highlighted by the adoption of checkpoint inhibitors and anti-angiogenic agents in combination—the study adds important context for refining therapeutic strategies.