IMbrave150
The trial that ended the sorafenib era: immunotherapy plus an anti-VEGF antibody became the new first-line standard for liver cancer.
Updated OS 19.2 vs 13.4 months (HR 0.66); PFS 6.9 vs 4.3 months; ORR 30% vs 11%. First regimen to beat sorafenib on OS. Requires endoscopy for varices because of bleeding risk with bevacizumab.
Setting
First-line unresectable HCC: atezolizumab + bevacizumab vs sorafenib
Phase
Phase 3
Sponsor
Roche
Registry
Headline result
OS 19.2 vs 13.4 months, HR 0.66.
Reported
2020
Enrolled
501
Replication
Consistent with real-world cohorts and with the anti-VEGF + PD-(L)1 class effect seen in CARES-310 and ORIENT-32.
In plain words
What these results mean for people, not percentages
Overall survival (updated)primarysurvival endpoint
- Median 19.2 vs 13.4 months with Atezolizumab + bevacizumab compared with Sorafenib; about 5.8 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 34 percent lower chance of the event at any given time (hazard ratio 0.66, likely range 0.52 to 0.85).
- Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
Progression-free survivalprimarysurrogate endpoint
- Median 6.9 vs 4.3 months with Atezolizumab + bevacizumab compared with Sorafenib; about 2.6 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 35 percent lower chance of the event at any given time (hazard ratio 0.65).
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
Objective response rateresponse endpoint
- 30 vs 11 out of 100 had their tumour shrink with Atezolizumab + bevacizumab compared with Sorafenib; 19 more per 100.
- Roughly one extra person helped for every 5 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- A response rate counts how many people had their tumours shrink by a set amount; shrinking is encouraging but does not by itself show that people live longer or feel better.
Be careful
- These results apply to the people the trial enrolled: First-line unresectable HCC: atezolizumab + bevacizumab vs sorafenib. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
501 participants enrolled.
Overall survival (updated)primary
HR 0.66 (0.52–0.85)
Atezolizumab + bevacizumab
19.2 mo
Sorafenib
13.4 mo
Progression-free survivalprimary
HR 0.65
Atezolizumab + bevacizumab
6.9 mo
Sorafenib
4.3 mo
Objective response rate
Atezolizumab + bevacizumab30 of 100
Sorafenib11 of 100
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survival (updated)primary | Atezolizumab + bevacizumab | 336 | 19.2 months | 0.66 (0.52–0.85) | — | — |
| Sorafenib | 165 | 13.4 months | ||||
| Progression-free survivalprimary | Atezolizumab + bevacizumab | — | 6.9 months | 0.65 | — | — |
| Sorafenib | — | 4.3 months | ||||
| Objective response rate | Atezolizumab + bevacizumab | — | 30% | — | — | — |
| Sorafenib | — | 11% |
Replication
Consistent with real-world cohorts and with the anti-VEGF + PD-(L)1 class effect seen in CARES-310 and ORIENT-32.