Dr. Patel on Selecting Patients for Treatment With Atezolizumab/Bevacizumab in HCC

Monica A. Patel, MD, an assistant professor of Hematology, Medical Oncology and Palliative Care at the University of Wisconsin Carbone Cancer Center, discusses factors that determine whether a patient with hepatocellular carcinoma (HCC) is a good candidate to receive a combination of atezolizumab (Tecentriq) and bevacizumab (Avastin).

In the phase 3 IMbrave150 trial (NCT03434379), the combination of atezolizumab and bevacizumab significantly improved overall survival in patients with HCC compared with sorafenib (Nexavar), Patel says. These improvements were especially significant for those with advanced, unresectable disease due to having limited treatment options, Patel notes.

However, while this treatment regimen is now considered a standard of care first-line therapy, it may not be an appropriate option for all patients, Patel explains. For example, in patients with liver cirrhosis or esophageal varices that may be either untreated or recently treated, treatment with bevacizumab may not be the best option, according to Patel.

For patients with a good functional status who can tolerate these agents, atezolizumab/bevacizumab could be a feasible option, however for other patients, different treatment regimens may need to be considered, Patel concludes.