Atezolizumab plus Bevacizumab with or without Transarterial Chemoembolization as First-Line Treatment for Barcelona Clinic Liver Cancer Stage C Hepatocellular Carcinoma: A Nationwide Multicenter Retrospective Study.
15 affiliations
- 1Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
- 2Department of Interventional Therapy II, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
- 3Department of Interventional Radiology, Harbin Medical University Cancer Hospital, Harbin, China.
- 4Department of Interventional Radiology, The First Hospital of China Medical University, Liaoning, China.
- 5Department of Interventional Treatment, Tianjin Cancer Hospital Airport Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer , Tianjin, China.
- 6Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
- 7Department of Oncology and Vascular Intervention, First Hospital of Shanxi Medical University, Shanxi Provincial Clinical Research Center for Interventional Medicine, Taiyuan, China.
- 8Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China.
- 9Department of Hepatobiliary and Pancreatic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
- 10Vascular and Interventional Department, Chongqing University Cancer Hospital, Chongqing, China.
- 11Department of Interventional Radiology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.
- 12Department of Minimally Invasive Interventional Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China.
- 13Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.
- 14Intervention Center, West China Hospital, Sichuan University, Chengdu, China.
- 15Department of Interventional Therapy, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
Abstract
Introduction
Atezolizumab plus bevacizumab (Atezo/Bev) has been recommended globally for patients with Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC); however, this regimen has shown modest survival benefits. Therefore, this study aimed to assess the efficacy and safety of Atezo/Bev with or without transarterial chemoembolization (TACE) as first-line treatment for BCLC C HCC.Methods
This nationwide multicenter retrospective cohort study recruited patients with BCLC stage C HCC from 14 medical centres who received TACE combined with Atezo/Bev (TACE+Atezo/Bev) or Atezo/Bev alone as first-line treatment between October 2020 and January 2025. To mitigate potential confounding imbalances between groups, propensity score matching (PSM) and stabilized inverse probability of treatment weighting (sIPTW) were applied. Overall survival (OS) was set as the primary endpoint, with progression-free survival (PFS), objective response rate (ORR), and safety assessed as the secondary endpoints.Results
Of the 256 patients included in the analysis, 154 received TACE+Atezo/Bev and 102 received Atezo/Bev. After PSM, analysis of 96 patients per group showed that the TACE+Atezo/Bev group significantly extended the median OS (25.9 months vs. 15.2 months, p < 0.001) and PFS (15.8 months vs. 7.4 months, p < 0.001), compared with the Atezo/Bev group. Post-application of sIPTW, 154 patients were assigned to the TACE+Atezo/Bev group and 102 to the Atezo/Bev group, and the median OS (25.3 vs. 15.4 months, p < 0.001) and PFS (15.5 vs. 7.5 months, p < 0.001) were significantly longer in the TACE+Atezo/Bev group than in the Atezo/Bev group. A higher ORR was observed in the TACE+Atezo/Bev group compared with the Atezo/Bev group (primary cohort: 48.7% vs. 31.4%, p = 0.009; PSM cohort: 51.0% vs. 31.2%, p = 0.008; sIPTW cohort: 50.6% vs. 32.0%, p = 0.005). Moreover, Grade 3/4 adverse events (AEs) occurred in 60 patients (39.0%) in the TACE+Atezo/Bev group and 34 patients (33.3%) in the Atezo/Bev group.Conclusion
Compared with Atezo/Bev alone, TACE+Atezo/Bev may significantly improve ORR, PFS, and OS as first-line treatment for BCLC stage C HCC, while maintaining an acceptable safety profile.
Related
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BibTeX
@article{zhang2026atezolizumab,
title = {{Atezolizumab plus Bevacizumab with or without Transarterial Chemoembolization as First-Line Treatment for Barcelona Clinic Liver Cancer Stage C Hepatocellular Carcinoma: A Nationwide Multicenter Retrospective Study.}},
author = {Xiao-Wu Zhang and Li-Wei Deng and Yin-Gen Luo and Yin-Fa Xie and Rui-Bao Liu and Hai-Bo Shao and Tong-Guo Si and Dui-Ping Feng and Jian Wang and Yu Zhang and Qing-Dong Li and Hong-Tao Hu and Wei-Jun Fan and Peng Song and Li-Nan Yin and Yan Wang and Yi Chen and Tian-Shi Lv and Yong Xie and Tian-Yi Hua and Jing Xiao and Rui-Can Nie and Lu-Jun Shen and Zhi-Ming Xuan and Chang Liu and Xue-Gang Yang and Xu Chang and Xiao Li},
journal = {Liver cancer},
year = {2026},
month = sep,
doi = {10.1159/lic/admag010},
url = {https://europepmc.org/article/MED/42924094},
note = {CC BY},
}
RIS
TY - JOUR
TI - Atezolizumab plus Bevacizumab with or without Transarterial Chemoembolization as First-Line Treatment for Barcelona Clinic Liver Cancer Stage C Hepatocellular Carcinoma: A Nationwide Multicenter Retrospective Study.
AU - Xiao-Wu Zhang
AU - Li-Wei Deng
AU - Yin-Gen Luo
AU - Yin-Fa Xie
AU - Rui-Bao Liu
AU - Hai-Bo Shao
AU - Tong-Guo Si
AU - Dui-Ping Feng
AU - Jian Wang
AU - Yu Zhang
AU - Qing-Dong Li
AU - Hong-Tao Hu
AU - Wei-Jun Fan
AU - Peng Song
AU - Li-Nan Yin
AU - Yan Wang
AU - Yi Chen
AU - Tian-Shi Lv
AU - Yong Xie
AU - Tian-Yi Hua
AU - Jing Xiao
AU - Rui-Can Nie
AU - Lu-Jun Shen
AU - Zhi-Ming Xuan
AU - Chang Liu
AU - Xue-Gang Yang
AU - Xu Chang
AU - Xiao Li
PY - 2026
DA - 2026/09/05
JO - Liver cancer
DO - 10.1159/lic/admag010
UR - https://europepmc.org/article/MED/42924094
AB - Introduction Atezolizumab plus bevacizumab (Atezo/Bev) has been recommended globally for patients with Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC); however, this regimen has shown modest survival benefits. Therefore, this study aimed to assess the efficacy and safety of Atezo/Bev with or without transarterial chemoembolization (TACE) as first-line treatment for BCLC C HCC.Methods This nationwide multicenter retrospective cohort study recruited patients with BCLC stage C HCC from 14 medical centres who received TACE combined with Atezo/Bev (TACE+Atezo/Bev) or Atezo/Bev alone as first-line treatment between October 2020 and January 2025. To mitigate potential confounding imbalances between groups, propensity score matching (PSM) and stabilized inverse probability of treatment weighting (sIPTW) were applied. Overall survival (OS) was set as the primary endpoint, with progression-free survival (PFS), objective response rate (ORR), and safety assessed as the secondary endpoints.Results Of the 256 patients included in the analysis, 154 received TACE+Atezo/Bev and 102 received Atezo/Bev. After PSM, analysis of 96 patients per group showed that the TACE+Atezo/Bev group significantly extended the median OS (25.9 months vs. 15.2 months, p < 0.001) and PFS (15.8 months vs. 7.4 months, p < 0.001), compared with the Atezo/Bev group. Post-application of sIPTW, 154 patients were assigned to the TACE+Atezo/Bev group and 102 to the Atezo/Bev group, and the median OS (25.3 vs. 15.4 months, p < 0.001) and PFS (15.5 vs. 7.5 months, p < 0.001) were significantly longer in the TACE+Atezo/Bev group than in the Atezo/Bev group. A higher ORR was observed in the TACE+Atezo/Bev group compared with the Atezo/Bev group (primary cohort: 48.7% vs. 31.4%, p = 0.009; PSM cohort: 51.0% vs. 31.2%, p = 0.008; sIPTW cohort: 50.6% vs. 32.0%, p = 0.005). Moreover, Grade 3/4 adverse events (AEs) occurred in 60 patients (39.0%) in the TACE+Atezo/Bev group and 34 patients (33.3%) in the Atezo/Bev group.Conclusion Compared with Atezo/Bev alone, TACE+Atezo/Bev may significantly improve ORR, PFS, and OS as first-line treatment for BCLC stage C HCC, while maintaining an acceptable safety profile.
SN - 2235-1795
SN - 1664-5553
ER -