2025/09/01 by Xiao-Qian Xu, Wei-Ming Li, Lichen Shi +7 · 1 voice
Medicine · #Hepatocellular Carcinoma Treatment and Prognosis #Silymarin and Mushroom Poisoning #Colorectal Cancer Treatments and Studies
paper · pdf · doi:10.1093/oncolo/oyaf269
openalex publication_date 2025/09/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30
IMPORTANCE: Atezolizumab (Atez) combined with bevacizumab (Bev) is the recommended first-line treatment for unresectable hepatocellular carcinoma (HCC). However, the clinical impact of temporary interruptions of Atez and Bev on treatment outcomes remains unclear. OBJECTIVE: To evaluate the association between temporary interruptions of Atez or Bev and survival outcomes among patients with unresectable HCC. DESIGN: Exploratory post hoc analysis of patient-level data from the phase 3 IMbrave150 (NCT03434379) trial. SETTING: Global, multicenter, randomized phase 3 trial designed to evaluate the therapeutic benefit of Atez plus Bev compared with sorafenib in patients with unresectable HCC. PARTICIPANTS: A total of 251 patients with unresectable HCC who received Atez and Bev in the IMbrave150 trial. EXPOSURES: Temporary interruptions of Atez or Bev during treatment. MAIN OUTCOMES AND MEASURES: Overall survival (OS) and progression-free survival (PFS). RESULTS: Among 251 patients treated with Atez/Bev, 79 (31.5%) experienced Atez interruptions and 86 (34.3%) had Bev interruptions. Interruptions were not significantly associated with OS (HR = 1.57, 95% CI: 0.90-2.73 for Atez, HR = 0.50, 95% CI: 0.16-1.53 for Bev). However, both were significantly associated with improved PFS (HR = 0.56, 95% CI: 0.34-0.92 for Atez and HR = 0.61, 95% CI: 0.39-0.94 for Bev). Subgroup analyses showed that positive association of PFS and interruptions was primarily observed in patients with events or treatment duration <12 months. Early (within 6 months) and late interruptions (after 6 months) showed trends toward longer PFS but were not statistically significant (HR = 0.56, 95% CI: 0.27-1.15 and HR = 0.57, 95% CI: 0.29-1.09 for Atez, HR = 0.61, 95% CI: 0.37-1.02, and HR = 0.60, 95% CI: 0.29-1.27 for Bev). CONCLUSIONS AND RELEVANCE: In this exploratory analysis, temporary interruptions of Atez or Bev were not associated with worse survival outcomes in patients with unresectable HCC. Prospective studies are needed to validate these findings.