IMbrave050: adjuvant atezolizumab plus bevacizumab versus active surveillance after resection or ablation of high-risk hepatocellular carcinoma
A year of atezolizumab plus bevacizumab after surgery or ablation for high-risk liver cancer initially reduced recurrences, but the benefit disappeared with longer follow-up, so there is still no proven adjuvant therapy.
Overview
Phase 3 trial of 668 patients with hepatocellular carcinoma at high risk of recurrence after resection or ablation randomised to 12 months of atezolizumab plus bevacizumab or active surveillance.
At the first interim analysis recurrence-free survival favoured treatment (hazard ratio 0.72), but the updated analysis showed the curves converging (hazard ratio 0.90) with no overall survival benefit; bleeding and immune-related events occurred in the treatment arm.
- Interim recurrence-free survival hazard ratio 0.72; updated hazard ratio 0.90 (not significant).
- No overall survival benefit.
Adjuvant immunotherapy is not standard after curative treatment of hepatocellular carcinoma; surveillance, antiviral therapy and risk factor control remain the approach.
- Early positive result was widely reported before the later negative update.
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