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Peer-reviewedCC BY-NCLiver cancer

Curative Locoregional Therapy following Objective Response to Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma.

  • Yu-Yun Shao1,2,3
  • San-Chi Chen4,5
  • Kun-Ming Rau6
  • Teng-Yu Lee7
  • Stephen L Chan8
  • Ken Liu9
  • Hsueh-Chou Lai10
  • Jacob George11
  • Cameron Gofton12
  • Siraphong Putraveephong13
  • Yin-Hsun Feng14
  • Ming-Yang Lee15
15 more authors
  • Jie XinJoycelyn Lee16
  • David Tai16
  • Suat Ying Lee16
  • Yen-Hao Chen17
  • Tsung-Che Wu1,3,18
  • Lein-Ray Mo19
  • Wan Zamaniah Wi20
  • Cosmas Rinaldi A Lesmana21,22
  • Cheng Vai Hui23
  • Shu Sen Sam Li24
  • Irsan Hasan21,22
  • Landon L Chan8
  • Melinda Nguyen9
  • Madhawa De Silva25
  • Chien-Huai Chuang1,2,3
25 affiliations
  1. 1Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
  2. 2Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan.
  3. 3Graduate Institute of Oncology, National Taiwan University School of Medicine, Taipei, Taiwan.
  4. 4Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.
  5. 5School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
  6. 6Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung, Taiwan.
  7. 7Division of Gastroenterology & Hepatology, Taichung Veterans General Hospital; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
  8. 8State Key Laboratory of Translational Oncology, Department of Clinical Oncology, Sir YK Pao Centre for Cancer, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR.
  9. 9AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, Australia.
  10. 10Division of Hepatology and Gastroenterology, Department of Internal Medicine, Taichung Municipal Geriatric Rehabilitation General Hospital, Center for Digestive Disease, Department of Internal Medicine, China Medical University Hospital, School of Chinese Medicine, China Medical University, Taichung, Taiwan.
  11. 11Storr Liver Centre, The Westmead Millennium Institute for Medical Research, Westmead Hospital and University of Sydney, Camperdown, NSW, Australia.
  12. 12Department of Gastroenterology and Hepatology, Royal North Shore Hospital, Sydney, NSW, Australia.
  13. 13Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
  14. 14Division of Hematology and Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
  15. 15Department of Internal Medicine, Chiayi Christian Hospital, Chiayi, Taiwan.
  16. 16Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
  17. 17Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
  18. 18Department of Oncology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.
  19. 19Department of Gastroenterology and Hepatology, Tainan Municipal Hospital, Tainan, Taiwan.
  20. 20Department of Clinical Oncology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
  21. 21Department of Gastroenterology and Hepatology, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia.
  22. 22Gastrointestinal Cancer Centre, Mochtar Riyadi Comprehensive Cancer Centre, Siloam Semanggi Hospital, Jakarta, Indonesia.
  23. 23Department of Oncology, Hospital Centre S. Januario, Macao, Macau.
  24. 24Department of General Surgery, Hospital Centre S. Januario, Macao, Macau.
  25. 25Department of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, Australia.
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Abstract

Introduction

Atezolizumab plus bevacizumab (Atezo-Bev) is a standard first-line systemic therapy for unresectable hepatocellular carcinoma (HCC). We aimed to explore the benefits of adding curative locoregional therapy (LRT) to patients who achieve a partial response (PR) to Atezo-Bev treatment.Methods

This multinational retrospective study enrolled patients who received Atezo-Bev as first-line systemic therapy for unresectable HCC and reached complete response (CR) or PR. Patients were categorized into three cohorts: patients who underwent curative LRT after PR, patients with PR but did not receive curative LRT, and patients achieving CR without LRT. Curative LRT included surgery, ablation, and definitive radiotherapy with imaging evidence showing disease-free status afterward.Results

A total of 243 patients were enrolled from 8 countries or regions; 31 patients received curative LRT after PR, 180 patients obtained PR but did not receive curative LRT, and 32 patients achieved CR without LRT. The curative-LRT group, compared with patients who did not receive curative LRT after PR, exhibited significantly longer PFS (median, 44.4 months vs. 18.2 months, p = 0.004) and overall survival (OS) (median, not reached vs. 34.3 months, p < 0.001). The differences remained significant after inverse probability of treatment weighting (IPTW) adjustment. By contrast, whether before or after IPTW adjustment, the curative-LRT group did not exhibit statistically significant difference in PFS, OS, and recurrence-free survival from patients who obtained CR without curative LRT.Conclusion

Curative LRT may consolidate the efficacy of Atezo-Bev in patients achieving a PR, potentially prolonging survival compared to systemic therapy alone.

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Cite

BibTeXRIS
BibTeX
@article{shao2026curative,
  title = {{Curative Locoregional Therapy following Objective Response to Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma.}},
  author = {Yu-Yun Shao and San-Chi Chen and Kun-Ming Rau and Teng-Yu Lee and Stephen L Chan and Ken Liu and Hsueh-Chou Lai and Jacob George and Cameron Gofton and Siraphong Putraveephong and Yin-Hsun Feng and Ming-Yang Lee and Jie XinJoycelyn Lee and David Tai and Suat Ying Lee and Yen-Hao Chen and Tsung-Che Wu and Lein-Ray Mo and Wan Zamaniah Wi and Cosmas Rinaldi A Lesmana and Cheng Vai Hui and Shu Sen Sam Li and Irsan Hasan and Landon L Chan and Melinda Nguyen and Madhawa De Silva and Chien-Huai Chuang},
  journal = {Liver cancer},
  year = {2026},
  month = aug,
  doi = {10.1159/lic/admag004},
  url = {https://europepmc.org/article/MED/42923539},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Curative Locoregional Therapy following Objective Response to Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma.
AU  - Yu-Yun Shao
AU  - San-Chi Chen
AU  - Kun-Ming Rau
AU  - Teng-Yu Lee
AU  - Stephen L Chan
AU  - Ken Liu
AU  - Hsueh-Chou Lai
AU  - Jacob George
AU  - Cameron Gofton
AU  - Siraphong Putraveephong
AU  - Yin-Hsun Feng
AU  - Ming-Yang Lee
AU  - Jie XinJoycelyn Lee
AU  - David Tai
AU  - Suat Ying Lee
AU  - Yen-Hao Chen
AU  - Tsung-Che Wu
AU  - Lein-Ray Mo
AU  - Wan Zamaniah Wi
AU  - Cosmas Rinaldi A Lesmana
AU  - Cheng Vai Hui
AU  - Shu Sen Sam Li
AU  - Irsan Hasan
AU  - Landon L Chan
AU  - Melinda Nguyen
AU  - Madhawa De Silva
AU  - Chien-Huai Chuang
PY  - 2026
DA  - 2026/08/12
JO  - Liver cancer
DO  - 10.1159/lic/admag004
UR  - https://europepmc.org/article/MED/42923539
AB  - Introduction  Atezolizumab plus bevacizumab (Atezo-Bev) is a standard first-line systemic therapy for unresectable hepatocellular carcinoma (HCC). We aimed to explore the benefits of adding curative locoregional therapy (LRT) to patients who achieve a partial response (PR) to Atezo-Bev treatment.Methods  This multinational retrospective study enrolled patients who received Atezo-Bev as first-line systemic therapy for unresectable HCC and reached complete response (CR) or PR. Patients were categorized into three cohorts: patients who underwent curative LRT after PR, patients with PR but did not receive curative LRT, and patients achieving CR without LRT. Curative LRT included surgery, ablation, and definitive radiotherapy with imaging evidence showing disease-free status afterward.Results  A total of 243 patients were enrolled from 8 countries or regions; 31 patients received curative LRT after PR, 180 patients obtained PR but did not receive curative LRT, and 32 patients achieved CR without LRT. The curative-LRT group, compared with patients who did not receive curative LRT after PR, exhibited significantly longer PFS (median, 44.4 months vs. 18.2 months, p = 0.004) and overall survival (OS) (median, not reached vs. 34.3 months, p < 0.001). The differences remained significant after inverse probability of treatment weighting (IPTW) adjustment. By contrast, whether before or after IPTW adjustment, the curative-LRT group did not exhibit statistically significant difference in PFS, OS, and recurrence-free survival from patients who obtained CR without curative LRT.Conclusion  Curative LRT may consolidate the efficacy of Atezo-Bev in patients achieving a PR, potentially prolonging survival compared to systemic therapy alone.
SN  - 2235-1795
SN  - 1664-5553
ER  -