Background
Although the combination of atezolizumab and bevacizumab (ATZ + BEV) is a standard treatment for advanced hepatocellular carcinoma (HCC), strategies for addressing treatment failure and prognostic factors of post‐progression survival (PPS) remain unestablished.
Methods
We conducted a multicentre retrospective study to evaluate PPS following ATZ + BEV treatment in patients with advanced HCC. We classified the patients into three groups: BCLC stage B and BCLC stage C without or with new extrahepatic lesions (BCLCp‐C1 and BCLCp‐C2, respectively) at the time of progression.
Results
Of the 204 patients who started ATZ + BEV treatment between October 2020 and September 2022, 110 showed disease progression, with 33, 55 and 22 showing the BCLCp‐B, BCLCp‐C1 and BCLCp‐C2 stages of the disease, respectively. Specifically, patients with the BCLCp‐B stage of the disease showed better overall survival than those with the BCLCp‐C1 and BCLCp‐C2 stages (hazard ratios: 1.93 [95% confidence interval, CI, 1.06–3.51] and 2.64 [95% CI, 1.32–5.30] for HCC stages BCLCp‐C1 and BCLCp‐C2, respectively). Via multivariable analysis, we identified the BCLCp‐C1 and BCLCp‐C2 stages, as well as performance status, Child–Pugh class and alpha‐fetoprotein as poor prognostic factors for PPS.
Conclusions
BCLCp‐B1 stage was identified as a better prognostic factor for PPS following ATZ + BEV treatment compared with BCLCp‐C1 and BCLCp‐C2 stages. This may help in making decisions regarding subsequent treatment after ATZ + BEV.