Adjuvant treatment may delay recurrence after surgical resection in patients with liver cancer (28% reduced risk of recurrence)

Medical Xpress / American Association for Cancer Research / AACR Annual Meeting 2023 ^ | April 17, 2023 | Pierce Chow, FRCS(E), Ph.D. et al

[ConservativeMind]

Adjuvant therapy with atezolizumab (Tecentriq) and bevacizumab (Avastin) increased recurrence-free survival of patients with hepatocellular carcinoma (HCC) following surgical resection or ablation, according to the results from the phase III IMbrave050 clinical trial.

The mainstays of curative therapies for early-stage HCC include surgical resection and thermal ablation, a treatment that destroys the cancer cells with heat or cold. However, the risk of recurrence reaches 70%–80% five years after resection or ablation with curative intent, said Pierce Chow, FRCS(E), Ph.D.

According to the results of an interim analysis conducted after a median follow-up of 17.4 months, the trial met its primary endpoint, and the combination of atezolizumab and bevacizumab significantly increased IRF-RFS when used as adjuvant therapy following surgical resection or ablation. Patients who received the combination treatment had their risk of recurrence or death reduced by 28% compared with patients in the active surveillance arm. At this timepoint, the median IRF-RFS was not reached for either arm.

Chow noted that the patients stayed on treatment longer than in the previous IMbrave150 trial that evaluated the same combination of drugs for unresectable HCC. "Despite the longer duration of treatment, the incidence of serious therapy-related adverse events was comparable to that in the IMbrave150 trial, indicating tolerability of this regimen when used as adjuvant therapy," he said.

Chow added that better clinical outcomes following treatment with this adjuvant regimen might also have an impact on the clinical indications for surgical resection and ablation in HCC. "Currently, surgery is not offered to many patients with potentially resectable disease if rapid recurrence is expected based on tumor burden or the presence of vascular invasion," said Chow. "The availability of an efficacious adjuvant therapy may lead to a reassessment of which patients may benefit from surgical resection."

[ConservativeMind]

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