Prognostic Significance of Response Dynamics in Atezolizumab plus Bevacizumab-Treated Hepatocellular Carcinoma: A Multicenter Real-World Validation Study.
4 affiliations
- 1Department of Hepatobiliary Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
- 2Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
- 3State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
- 4Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China.
Abstract
Background
Radiological response dynamics may provide prognostic information beyond conventional response categories in patients with unresectable hepatocellular carcinoma (HCC) receiving atezolizumab plus bevacizumab. Building upon findings from the IMbrave150 trial, we evaluated the prognostic significance of depth of response (DpR), duration of response (DoR), and time to response (TTR) in a real-world cohort.Methods
This retrospective multicenter study included 183 treatment-naïve patients with unresectable HCC treated with atezolizumab plus bevacizumab between November 2020 and September 2024. Tumor response was assessed according to mRECIST. Associations of DpR, DoR, and TTR with overall survival (OS) and progression-free survival (PFS) were evaluated using landmark analyses and time-dependent Cox analyses.Results
Deeper tumor response, longer DoR, and ≥50% reductions in serologic biomarker correlated with improved survival. Patients who achieved an early response (≤2 months) tended to have less favorable survival outcomes than those with a later response. Multivariate analysis confirmed DoR (HR = 0.40; 95% CI: 0.30-0.55; p < 0.001) and DpR (HR = 0.45; 95% CI: 0.38-0.55; p < 0.001) as independent predictors for improved OS, while early response independently predicted worse OS (HR = 1.64; 95% CI: 1.26-2.15; p < 0.001). Similar trends were observed for PFS. Exploratory analyses suggested a potential association between conversion surgery and prolonged OS.Conclusion
DpR and DoR were independently associated with survival outcomes in patients with unresectable HCC receiving atezolizumab plus bevacizumab, extending and validating previous findings from IMbrave150 in a real-world setting. The prognostic significance of TTR and conversion surgery warrants further prospective investigation.
Related
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- Early antibiotic exposure, but not late exposure, negatively affects the clinical outcomes of first-line atezolizumab plus bevacizumab in patients with unresectable hepatocellular carcinoma
- Acute colonic variceal bleeding treated with coil-assisted retrograde transvenous obliteration following atezolizumab-bevacizumab therapy for advanced hepatocellular carcinoma: A case report.
- Real-world evidence for atezolizumab with bevacizumab for unresectable hepatocellular carcinoma: a multicentre UK Midlands cohort
BibTeX
@article{guan2026prognostic,
title = {{Prognostic Significance of Response Dynamics in Atezolizumab plus Bevacizumab-Treated Hepatocellular Carcinoma: A Multicenter Real-World Validation Study.}},
author = {Renguo Guan and Kaijun Huang and Zehao Zheng and Zhen Zhao and Meishi Tang and Haosheng Jin and Jie Mei and Ye Lin},
journal = {Liver cancer},
year = {2026},
month = jul,
doi = {10.1159/lic/admag002},
url = {https://europepmc.org/article/MED/42924060},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Prognostic Significance of Response Dynamics in Atezolizumab plus Bevacizumab-Treated Hepatocellular Carcinoma: A Multicenter Real-World Validation Study.
AU - Renguo Guan
AU - Kaijun Huang
AU - Zehao Zheng
AU - Zhen Zhao
AU - Meishi Tang
AU - Haosheng Jin
AU - Jie Mei
AU - Ye Lin
PY - 2026
DA - 2026/07/30
JO - Liver cancer
DO - 10.1159/lic/admag002
UR - https://europepmc.org/article/MED/42924060
AB - Background Radiological response dynamics may provide prognostic information beyond conventional response categories in patients with unresectable hepatocellular carcinoma (HCC) receiving atezolizumab plus bevacizumab. Building upon findings from the IMbrave150 trial, we evaluated the prognostic significance of depth of response (DpR), duration of response (DoR), and time to response (TTR) in a real-world cohort.Methods This retrospective multicenter study included 183 treatment-naïve patients with unresectable HCC treated with atezolizumab plus bevacizumab between November 2020 and September 2024. Tumor response was assessed according to mRECIST. Associations of DpR, DoR, and TTR with overall survival (OS) and progression-free survival (PFS) were evaluated using landmark analyses and time-dependent Cox analyses.Results Deeper tumor response, longer DoR, and ≥50% reductions in serologic biomarker correlated with improved survival. Patients who achieved an early response (≤2 months) tended to have less favorable survival outcomes than those with a later response. Multivariate analysis confirmed DoR (HR = 0.40; 95% CI: 0.30-0.55; p < 0.001) and DpR (HR = 0.45; 95% CI: 0.38-0.55; p < 0.001) as independent predictors for improved OS, while early response independently predicted worse OS (HR = 1.64; 95% CI: 1.26-2.15; p < 0.001). Similar trends were observed for PFS. Exploratory analyses suggested a potential association between conversion surgery and prolonged OS.Conclusion DpR and DoR were independently associated with survival outcomes in patients with unresectable HCC receiving atezolizumab plus bevacizumab, extending and validating previous findings from IMbrave150 in a real-world setting. The prognostic significance of TTR and conversion surgery warrants further prospective investigation.
SN - 2235-1795
SN - 1664-5553
ER -