Chirurgia del Fegato a Firenze!

Dal 1° Marzo 2023, Chirurgia del Fegato sarà all'Università di Firenze
AOUC Azienda Ospedaliero-Universitaria Careggi - Largo Brambilla, 3 - 50134 Firenze

L’immunoterapia con Atezolizumab e Bevacizumab per l’Epatocarcinoma

Lo studio IMbrave150 (ClinicalTrials.gov number, NCT03434379), pubblicato sul The New England Journal of Medicine, mostra che la combinazione di atezolizumab e bevacizumab migliora sia la sopravvivenza globale che quella libera da progressione di malattia nei pazienti portatori di epatocarcinoma non resecabile rispetto al sorafenib.

La referenza bibliografica per questo evento è:

Richard S. Finn, Shukui Qin, Masafumi Ikeda, Peter R. Galle, Michel Ducreux, Tae-You Kim, Masatoshi Kudo, Valeriy Breder, Philippe Merle, Ahmed O. Kaseb, Daneng Li, Wendy Verret, Derek-Zhen Xu, Sairy Hernandez, Juan Liu, Chen Huang, Sohail Mulla, Yulei Wang, Ho Yeong Lim, Andrew X. Zhu, Ann-Lii Cheng: Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma. In: New England Journal of Medicine, vol. 382, no. 20, pp. 1894 – 1905, 2020, ISSN: 00284793, (Cited by: 1912; All Open Access, Bronze Open Access).

Abstract

BACKGROUND The combination of atezolizumab and bevacizumab showed encouraging antitumor activity and safety in a phase 1b trial involving patients with unresectable hepatocellular carcinoma. METHODS In a global, openlabel, phase 3 trial, patients with unresectable hepatocellular carcinoma who had not previously received systemic treatment were randomly assigned in a 2:1 ratio to receive either atezolizumab plus bevacizumab or sorafenib until unacceptable toxic effects occurred or there was a loss of clinical benefit. The coprimary end points were overall survival and progressionfree survival in the intentiontotreat population, as assessed at an independent review facility according to Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1). RESULTS The intentiontotreat population included 336 patients in the atezolizumab–bevacizumab group and 165 patients in the sorafenib group. At the time of the primary analysis (August 29, 2019), the hazard ratio for death with atezolizumab–bevacizumab as compared with sorafenib was 0.58 (95% confidence interval [CI], 0.42 to 0.79; P<0.001). Overall survival at 12 months was 67.2% (95% CI, 61.3 to 73.1) with atezolizumab–bevacizumab and 54.6% (95% CI, 45.2 to 64.0) with sorafenib. Median progressionfree survival was 6.8 months (95% CI, 5.7 to 8.3) and 4.3 months (95% CI, 4.0 to 5.6) in the respective groups (hazard ratio for disease progression or death, 0.59; 95% CI, 0.47 to 0.76; P<0.001). Grade 3 or 4 adverse events occurred in 56.5% of 329 patients who received at least one dose of atezolizumab–bevacizumab and in 55.1% of 156 patients who received at least one dose of sorafenib. Grade 3 or 4 hypertension occurred in 15.2% of patients in the atezolizumab–bevacizumab group; however, other highgrade toxic effects were infrequent. CONCLUSIONS In patients with unresectable hepatocellular carcinoma, atezolizumab combined with bevacizumab resulted in better overall and progressionfree survival outcomes than sorafenib. Copyright © 2020 Massachusetts Medical Society.

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Chirurgia del Fegato all'Università di Firenze!

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