Real-world outcomes of atezolizumab plus bevacizumab in patients with hepatocellular carcinoma: A retrospective cohort study

Abstract

Introduction . Hepatocellular carcinoma (HCC) ranks sixth in morbidity and third in mortality among oncological diseases in the world. The combination of atezolizumab (a PD-L1 inhibitor) and bevacizumab (anti-VEGF) is the standard of first-line systemic therapy for unresectable HCC based on the results of the randomized IMbrave150 trial. Data on the use of this scheme in real clinical practice in the Russian population remains limited. Aim. To assess the efficacy and safety of atezolizumab plus bevacizumab in HCC patients in a real-world single-center setting. Materials and methods. This retrospective cohort study included 15 patients with histologically or clinically confirmed HCC receiving atezolizumab 1200 mg + bevacizumab 15 mg/kg IV every 3 weeks at Medical Center Medical City (Tyumen) from 2021 to 2025. Results . The median age of the patients included in the study was 49.6 years (range 27.6–73.1 years; mean 51.9 ± 12.3 years). Male patients prevailed – 10 (66.7%), 5 (33.3%) women. Stage BCLC C – 66.7% (10/15), BCLC B – 5/15 (33.3%). Viral hepatitis C was detected in 46.7% (7/15) of patients, hepatitis B in 13.3% (2/15), and the viral etiology of HCC was not established in 40.0% (6/15) of patients. The medians of PFS and OS were not reached, and the median follow-up was 16 months. The average number of courses conducted is 9 (range 2–21). The ORR was 37.7%. Adverse events were reported in 26.7% (4/15) of patients; the most significant were grade 1–2 autoimmune hepatitis, thrombocytopenia, and ischemic stroke. Conclusion . Real-world data confirm the efficacy and manageable toxicity of atezolizumab plus bevacizumab in HCC.