Survival in patients receiving reduced dose intensity of bevacizumab for unresectable hepatocellular carcinoma

Abstract IMBrave 150 established atezolizumab and bevacizumab as the new standard for advanced hepatocellular carcinoma (HCC) treatment. However, the trial reported significant adverse events leading to bevacizumab dose interruptions or discontinuations. This retrospective, real-world analysis evalu...

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Main Authors: Dimity Ball, Jean-Charles Nault, Mathew Vithayathil, Manon Allaire, Nathalie Ganne-Carrié, Claudia Campani, Fabio Marra, Rohini Sharma
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:npj Precision Oncology
Online Access:https://doi.org/10.1038/s41698-025-00908-7
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author Dimity Ball
Jean-Charles Nault
Mathew Vithayathil
Manon Allaire
Nathalie Ganne-Carrié
Claudia Campani
Fabio Marra
Rohini Sharma
author_facet Dimity Ball
Jean-Charles Nault
Mathew Vithayathil
Manon Allaire
Nathalie Ganne-Carrié
Claudia Campani
Fabio Marra
Rohini Sharma
author_sort Dimity Ball
collection DOAJ
description Abstract IMBrave 150 established atezolizumab and bevacizumab as the new standard for advanced hepatocellular carcinoma (HCC) treatment. However, the trial reported significant adverse events leading to bevacizumab dose interruptions or discontinuations. This retrospective, real-world analysis evaluated the effect of reduced bevacizumab dose intensity on clinical outcomes in 354 patients receiving first-line combination immunotherapy for advanced HCC. To minimize immortal time bias, only those on therapy for over 3 months were included. Of 219 patients included in the landmark analysis, 52 received a reduced dose intensity of bevacizumab. The median relative dose intensity (RDTI) of bevacizumab was 75% (range 9.1–96.9%). There was no significant difference in progression-free survival (11.2 vs. 14.8 months, p = 0.5) or overall survival (20.4 vs. 26.8 months, p = 0.1) between those receiving 100% vs. reduced RDTI. Exploratory analysis showed that even doses under 75% had no survival impact. Treatment-related grade 3/4 adverse events occurred more frequently with RDTI (30.7% vs. 15.5%). Reduced bevacizumab doses do not impact survival.
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issn 2397-768X
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publishDate 2025-05-01
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series npj Precision Oncology
spelling doaj-art-e5a40712370d44bc9be09ecd4d402f952025-08-20T03:53:08ZengNature Portfolionpj Precision Oncology2397-768X2025-05-01911510.1038/s41698-025-00908-7Survival in patients receiving reduced dose intensity of bevacizumab for unresectable hepatocellular carcinomaDimity Ball0Jean-Charles Nault1Mathew Vithayathil2Manon Allaire3Nathalie Ganne-Carrié4Claudia Campani5Fabio Marra6Rohini Sharma7Department of Medical Oncology, Imperial College NHS Healthcare Trust, Hammersmith HospitalCentre de recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, team « Functional Genomics of Solid Tumors », Equipe labellisée Ligue Nationale Contre le Cancer, Labex OncoImmunologyDivision of Surgery and Cancer, Imperial College London, Hammersmith HospitalService d’Hépatolo-gastroentérologie, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, AP-HP, Sorbonne UniversitéCentre de recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, team « Functional Genomics of Solid Tumors », Equipe labellisée Ligue Nationale Contre le Cancer, Labex OncoImmunologyDipartimento di Medicina Sperimentale e Clinica, University of FlorenceDipartimento di Medicina Sperimentale e Clinica, University of FlorenceDivision of Surgery and Cancer, Imperial College London, Hammersmith HospitalAbstract IMBrave 150 established atezolizumab and bevacizumab as the new standard for advanced hepatocellular carcinoma (HCC) treatment. However, the trial reported significant adverse events leading to bevacizumab dose interruptions or discontinuations. This retrospective, real-world analysis evaluated the effect of reduced bevacizumab dose intensity on clinical outcomes in 354 patients receiving first-line combination immunotherapy for advanced HCC. To minimize immortal time bias, only those on therapy for over 3 months were included. Of 219 patients included in the landmark analysis, 52 received a reduced dose intensity of bevacizumab. The median relative dose intensity (RDTI) of bevacizumab was 75% (range 9.1–96.9%). There was no significant difference in progression-free survival (11.2 vs. 14.8 months, p = 0.5) or overall survival (20.4 vs. 26.8 months, p = 0.1) between those receiving 100% vs. reduced RDTI. Exploratory analysis showed that even doses under 75% had no survival impact. Treatment-related grade 3/4 adverse events occurred more frequently with RDTI (30.7% vs. 15.5%). Reduced bevacizumab doses do not impact survival.https://doi.org/10.1038/s41698-025-00908-7
spellingShingle Dimity Ball
Jean-Charles Nault
Mathew Vithayathil
Manon Allaire
Nathalie Ganne-Carrié
Claudia Campani
Fabio Marra
Rohini Sharma
Survival in patients receiving reduced dose intensity of bevacizumab for unresectable hepatocellular carcinoma
npj Precision Oncology
title Survival in patients receiving reduced dose intensity of bevacizumab for unresectable hepatocellular carcinoma
title_full Survival in patients receiving reduced dose intensity of bevacizumab for unresectable hepatocellular carcinoma
title_fullStr Survival in patients receiving reduced dose intensity of bevacizumab for unresectable hepatocellular carcinoma
title_full_unstemmed Survival in patients receiving reduced dose intensity of bevacizumab for unresectable hepatocellular carcinoma
title_short Survival in patients receiving reduced dose intensity of bevacizumab for unresectable hepatocellular carcinoma
title_sort survival in patients receiving reduced dose intensity of bevacizumab for unresectable hepatocellular carcinoma
url https://doi.org/10.1038/s41698-025-00908-7
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