CLINICAL CHARACTERISTICS AND SAFETY PROFILE OF ATEZOLIZUMAB/BEVACIZUMAB IN CARCINOMA HEPATOCELLULAR: EXPERIENCE OF A CENTER OF REFERENCE NATIONAL IN PERU

Introduction and Objectives

The high disease burden and limited survival of cirrhotic patients with hepatocarcinoma have led to the emphasis on the combination of atezolizumab and bevacizumab as first-line therapy.

To describe the clinical characteristics of patients with hepatocarcinoma treated with Atezolizumab/Bevacizumab in a Peruvian hospital.

Materials and Methods

Descriptive cross-sectional study that included adult patients diagnosed with hepatocarcinoma treated with Atezolizumab/Bevacizumab in the Liver and Transplant Service of the Edgardo Rebagliati Martins National Hospital.

Results

Twenty-three patients were evaluated, with a predominance of males (60.9%) and a preserved functional status in the entire cohort (100% with ECOG 0-1). All patients had compensated liver function (Child-Pugh A). The most common etiology of cirrhosis was metabolically associated steatotic liver disease (MASLD), with a prevalence of 52.2%. Regarding tumor stage, 43.5% were in intermediate stage (BCLC B) and 26.1% in advanced stage (BCLC C). The median survival from the start of treatment to the last follow-up was 13 months (interquartile range: 8). a 17). Treatment was well tolerated, with no adverse events reported in 86.9% of patients. According to RECIST criteria, 34.8% had a complete tumor response or stable disease. Five patients (21.7%) died during overall follow-up.

Conclusions

In this Peruvian cohort of patients with hepatocarcinoma, treatment with Atezolizumab/Bevacizumab showed acceptable survival.

Conflict of interest: None

Table 1. Clinical characteristics of the study population (n = 23 )

Characteristic??	n (%)
Sex
Female	9 (39.1)
Male	14 (60.9)
Age
<40 years old	1 (4.4)
41 to 60 years old	1 (4.4)
61 to 75 years old	15 (65.2)
> 75 years	6 (26.1)
Etiology of HCC
MASLD	12 (52.2)
Cholestasis	5 (21.7)
ALD	2 (8.7)
Hepatitis C	2 (8.7)
Hepatitis B	1 (4.4)
Autoimmune hepatitis	1 (4.4)
Albi Score
Grade 1	7 (30.4)
Grade 2	15 (65.2)
Grade 3	1 (4.4)
Child Pugh
A-5	10 (43.5)
A-6	13 (56.5)
Degree of varicose veins
Grade 1	10 (43.5)
Grade 2	3 (13.0)
Grade 3	1 (4.4)
Does not present varicose veins	9 (39.1)
Tube treatment for esophageal varices
No	18 (78.3)
Yes	5 (21.7)
Number of comorbidities*	1 (1 - 2)
HBP	13 (56.5)
DM2	10 (43.5)
Obesity	6 (26.1)
Overall survival from start of treatment to last follow-up in months*	13 (8 - 17)
Mortality Subanalysis?
3 months (23 patients)	4.35%
6 months (22 patients)	4.54%
12 months (14 patients)	14.3%
Adverse effect of treatment
None	20 (87.5)
Nephrotic syndrome?	1 (4.4)
Pulmonary thromboembolism	1 (4.4)
Pneumonitis	1 (4.4)
Local regional treatment
No	15 (65.2)
RFA	2 (8.7)
TACE	6 (26.1)
Tumor resection?
No	19 (82.6)
Yes	4 (17.4)
Vascular metastasis
No	21 (91.3)
Yes	2 (8.7)
Extrahepatic metastasis
No	18 (78.3)
Yes	5 (21.7)
Death
No	19 (82.6)
Yes	4 (17.4)