The Epidemiology of Patients Treated With ATZ+BEV in Real Life Setting

Overview

Hepatocellular carcinoma (HCC) is the sixth most prevalent cancer and the third most frequent cause of cancer-related death globally. This retrospective, multicentric study will be coordinated by Dr. Adrian Radu Vidra (Lead Investigator) from Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor" Cluj-Napoca (Coordinating Site) to further investigate the clinical and demographic profile of patients receiving first-line treatment with atezolizumab and bevacizumab in the real-world setting of clinical practice from Romania. Participants already taking the combination therapy as part of their regular medical care for HCC will be followed during 3 years.

The available information suggests that the ATZ plus BEV is safe and effective as first-line systemic therapy for patients with unresected HCC and advanced HCC. The overall efficacy and safety of the combination has been well established in the literature and from the various clinical studies. This combination has since replaced tyrosine kinase inhibitors as the standard for many patients. The combination significantly increases OS (median 19.2 months vs. 13.4 months with sorafenib) and objective response rates (30% vs. 11%), offering better disease control. The defined primary study outcome is describing the epidemiology of patients treated with ATZ+BEV in real-life setting. History of the disease, including etiology of liver disease, BCLC stage, MVI, EHS, Child-Pugh Score, ALBI grade, MELD, Betablocker medication, Prior treatment, Resection, Local ablation, TACE/SIRT, BMI, ALT, AST, TBL, Albumin, INR, AFP will be collected and presented. Data on baseline characteristics, radiological response, treatment patterns and adverse events will be summarized using descriptive statistics. Continuous variables will be presented shown as median and full range, and categorical variables will be reported as frequencies and percentages. Median duration of therapy was defined as the time from the first administration until the last administration of the drugs. Patients who still received atezolizumab with or without concomitant bevacizumab at data cut-off will be censored. Patients with at least one staging imaging assessment will be evaluated for radiological response. Data from patients, who died without radiologically confirmed tumor progression, will be censored at the date of the last radiological assessment or death. PFS is defined as the time from the date of the first therapy administration until radiological disease progression or death, whatever occurred first. Patients still alive and without radiologically confirmed progression at the date of the last contact or data cut-off will be censored. OS will be defined as the time from the start of the treatment with atezolizumab and bevacizumab until the date of death. Survival curves will be calculated with the Kaplan-Meier method and compared by means of the log-rank test. Safety assessment will consist of monitoring the incidence of all adverse events observed following the treatment with ATZ plus BEV, graded according to the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 5. Safety events will be stratified by type of events, grades, seriousness and will be collected at time points defined in the study flowchart.