Tecentriq-Avastin Combo Leads to ‘Longest Survival’ in Liver Cancer

Tecentriq-Avastin Combo Leads to ‘Longest Survival’ in Liver Cancer

First-line therapy with a combination of Tecentriq (atezolizumab) and Avastin (bevacizumab) significantly prolongs the survival of people with inoperable hepatocellular carcinoma (HCC) — the most common form of liver cancer — according to updated data from an ongoing Phase 3 trial.

The latest findings from the study, called IMbrave150 (NCT03434379), showed that the combination therapy lowered the risk of death by 34% compared with Nexavar (sorafenib), a current standard of care.

“These results show that Tecentriq in combination with Avastin provides the longest survival that we’ve ever seen in a front-line Phase III study in unresectable [inoperable] HCC,” Levi Garraway, MD, PhD, chief medical officer and head of global product development at Roche, said in a press release.

Roche’s subsidiary (Genentech) developed and currently markets both Tecentriq and Avastin.

The Tecentriq-Avastin combo also was better than Nexavar at delaying disease worsening and increasing the percentage of patients responding to treatment.

Altogether, Garraway said, the combination therapy “represents a significant treatment advancement for patients with this challenging malignancy.”

These updated findings from IMbrave150 were presented by Roche at the 2021 Gastrointestinal Cancers Symposium, a scientific meeting organized by the American Society of Clinical Oncology (ASCO). That meeting was held virtually Jan. 15–17.

Tecentriq and Avastin are two anti-cancer therapies that use different mechanisms to destroy cancer cells. While Tecentriq prevents cancer cells from exploiting a signaling pathway that helps them avoid being destroyed by the body’s immune cells, Avastin restricts tumors’ blood supply in order to reduce their growth.

The combination of Tecentriq and Avastin has been approved as a first-line therapy for patients with inoperable HCC in more than 60 countries worldwide, including the U.S., China, and Japan.

It also was approved by all members of the European Union.

All approvals were based on data from IMbrave150, a Phase 3 trial that assessed whether first-line treatment with the Tecentriq-Avastin combination is superior to Nexavar. The trial evaluated whether the combo therapy could prolong survival and delay disease progression in 501 patients with inoperable, locally advanced, or metastatic HCC.

Data from a primary analysis of the study showed that, after a median follow-up of 8.6 months, the Tecentriq-Avastin combo lowered the risk of death by 42%, and the risk of disease worsening or death by 41%, compared with Nexavar.

Moreover, the percentage of patients responding to treatment was higher among those given the combination therapy compared with those treated with Nexavar (27.3% vs. 11.9%).

Updated data from the trial, now announced by Roche, confirmed the survival benefits provided by the combination therapy.

After a median follow-up of 15.6 months, the Tecentriq-Avastin combo extended patients’ lives from a median of 13.4 to 19.2 months, reducing the risk of death by 34%, compared with Nexavar.

These survival benefits were even higher in a subpopulation of Chinese patients participating in the trial, in whom the combination therapy lowered the risk of death by 47%.

The combination therapy also prolonged the time patients lived without worsening from a median of 4.3 to 6.9 months, lowering the risk of disease progression or death by 35%.

In agreement with the study’s previous analysis, the percentage of patients responding to treatment was nearly three times higher in patients treated with the Tecentriq-Avastin combo, compared with those who received Nexavar (30% vs. 11%).

Likewise, the percentage of patients achieving complete (8% vs. less than 1%) or partial responses (22% vs. 11%), corresponding to complete or partial cancer elimination, was higher in those treated with the combination therapy.

Responses also lasted longer in those given the combo treatment (median of 18.1 vs. 14.9 months).

Safety analyses revealed the combination therapy had a safety profile that was consistent with that of Tecentriq and Avastin when administered separately. No new safety concerns were identified.

“After an additional year of follow-up, these data confirm the superiority of Tecentriq in combination with Avastin compared to sorafenib in patients with advanced HCC,” said Laura Kulik, MD, professor of medicine, interventional radiology and transplant at the Feinberg School of Medicine at Northwestern University, in Illinois.

“These results provide further confidence for physicians and patients in the use of this combination as first-line therapy,” added Kulik, who is also a member of the ASCO GI program committee.