Progression free survival in patients of HCC on atezolizumab/bevacizumab in Pakistan.

Abstract

46 Background: Liver cancers had been the second leading cause of cancer related deaths, globally and hepatocellular carcinoma (HCC) accounts for 75-85% of the primary liver malignancies. Recently, the combination of Atezolizumab-Bevacizumab (atezo-beva) had been considered to be the standard of care for unresectable HCC. This study aims to assess the impact of the atezo-beva combination therapy on patients with HCC in Pakistan that will help to improve the standard of care and could lead to better health outcomes for our patients. Methods: A retrospective, uni-center study was conducted among the patients of HCC presented in the oncology department of Hameed Latif Hospital, Lahore, Pakistan, with the sample size of 46. The diagnosed patients of unresectable HCC were included. The combination of Atezolizumab 1200mg and Bevacizumab 15mg per kg were administered intravenous every 3 weekly. The therapeutic response to treatment was assessed by CT or MRI after 3 months of initiation of treatment as per Response Evaluation Criteria in Solid Tumors for immunotherapy (iRECIST). Results: A total of 46 participants were included with the median age of 61.5 years. 91.3% and 8.7% participants were male and female, respectively. Majority, 78.3% had viral etiology for HCC and the median level of alpha fetoprotein (AFP) was 99.43 ng/ml. The response to atezo-beva combination after 4 cycles of treatment was partial response (45.17%), progressive disease (15.2%), and stable disease (10.9%). Moreover, the current status of the participants was as ongoing treatment (67.4%), progressive disease (13.0%), drug side effects (6.5%), lost to follow up (6.5%) and mortality (6.5%). Conclusions: The effect of atezo-beva combination on unresectable HCC showed the majority to have partial response. However further studies are needed to validate these findings as well as to assess the PFS and OS of atezo-beva combination in Pakistani population.