Dr. Kim on the Safety Profile of Atezolizumab/Bevacizumab in HCC

Richard D. Kim, MD, a medical oncologist within the Department of Gastrointestinal Oncology at Moffitt Cancer Center and an assistant professor of oncology with the University of South Florida College of Medicine, discusses the safety profile of the combination of atezolizumab (Tecentriq) and bevacizumab (Avastin) in hepatocellular carcinoma (HCC).

In May 2020, the combination received regulatory approval from the FDA for the frontline treatment of patients with unresectable or metastatic HCC based on findings from the phase 3 IMbrave150 trial. Atezolizumab/bevacizumab induced a 42% reduction in the risk of death compared with sorafenib (Nexavar) in the study.

Regarding safety, the regimen was well tolerated. Though, some patients did experience hypertension, Kim explains. Although concerns regarding the risk of perforation or variceal bleeding with the combination were noted, fewer than 5% of patients experienced this toxicity.

A quality-of-life (QOL) analysis demonstrated that the combination did not compromise QOL for patients, says Kim.

Notably, patients who enrolled in the IMbrave150 trial were fit patients, having had Child-Pugh A disease and good performance status. Given that sorafenib is associated with toxicities such as rash, fatigue, and hand-foot-skin reactions, atezolizumab/bevacizumab seems to be the preferred regimen regarding QOL, Kim concludes.