Researchers at the University of California, Los Angeles found that a first-line combination of atezolizumab, an immunotherapy drug that boosts the body’s natural defenses, and bevacizumab, an anti-angiogenesis drug that inhibits the growth of tumors’ blood vessels, significantly improves survival for people with hepatocellular carcinoma, the most common type of liver cancer.
The combination improved overall survival and reduced the risk of death by 42%. It also decreased the risk of the disease worsening by 41%, and the percentage of patients whose cancer shrank or disappeared more than doubled.
Tecentriq (atezolizumab) and Avastin (bevacizumab) are sponsored by Genentech, a member of the Roche Group.
Results from the clinical trial were published in the New England Journal of Medicine, and the combination is being reviewed for approval under FDA’s Real-Time Oncology Review pilot program.
Until now, no new first-line therapy has been shown to improve survival in advanced HCC since sorafenib was approved in 2007.
Atezolizumab and bevacizumab are monoclonal antibodies that have been used alone and in combination with other therapies to treat other cancers.
Atezolizumab targets a protein produced by cancer cells that shuts down the immune system’s infection-fighting T cells. Bevacizumab interferes with a tumor’s blood supply, preventing the cancer from growing and spreading through the body.
“By using these two drugs with different mechanisms of action together, we have increased the number of patients who respond to this treatment and have increased the duration of these responses as compared to the standard treatment, sorafenib,” Finn said.
The trial included 501 people, age 18 up, from multiple centers worldwide, who had advanced metastatic or unresectable hepatocellular carcinoma. Two-thirds of participants were randomly assigned to receive the atezolizumab and bevacizumab combination, while one-third received sorafenib.
Twelve months after the start of treatment, the rate of survival with the combination was 67.2%, compared with 54.6% for the group on sorafenib.