Most Read Articles
04 Oct 2020
Obesity does not appear to be strongly correlated with an increased risk for febrile neutropaenia during levofloxacin prophylaxis in patients with haematological malignancies receiving intermediate-risk myelosuppressive chemotherapy, suggests a study.
Roshini Claire Anthony, 25 Nov 2020

Initiation or switch to the single-tablet regimen of bictegravir/emtricitabine/tenofovir alafenamide (TAF) led to low HIV-1 RNA viral load in people living with HIV (PLHIV), according to the BICSTaR study presented at HIV Glasgow 2020.

09 Nov 2020
Use of corticosteroids appears to be an effective treatment for paediatric drug reaction with eosinophilia and systemic symptoms (DRESS), suggest the results of a recent study. In severe cases, corticosteroids used in conjunction with intravenous immunoglobulin result in fast clinical improvement.
Stephen Padilla, 10 Nov 2020
Patients with chronic obstructive pulmonary disease (COPD) seem to benefit from using chlorhexidine oral rinses twice daily as shown by the reduction in oral and sputum microbiota alpha diversity and by clinically significant improvements in COPD symptoms, according to a study presented at ID Week 2020.

Updated IMbrave150 analysis boosts safety profile of atezolizumab-bevacizumab for HCC

Audrey Abella
04 Sep 2020

Safety data from the phase III IMbrave150 trial reinforce the previously reported favourable safety profile of atezolizumab-bevacizumab compared with sorafenib for unresectable hepatocellular carcinoma (HCC).

The atezolizumab-bevacizumab regimen has recently gained the US FDA nod for this patient subgroup following the favourable results initially presented. [ESMO Asia 2019, abstract LBA3; ASCO GI 2020, abstract 476]

“Combined with [the] previous efficacy results, [our current] data suggest that atezolizumab-bevacizumab should be considered the new standard of care in patients with unresectable HCC who have not received previous systemic therapy,” said Professor Michel Ducreux from the Gustave Roussy Cancer Center in Villejuif, France, who presented the findings at ESMO GI 2020.

Of the initial study enrolees (n=501), 485 were included in the safety analysis. Atezolizumab 1,200 mg IV Q3W + bevacizumab 15 mg/kg IV Q3W (combo regimen), or sorafenib 400 mg BID, were given at a 2:1 ratio, until loss of clinical benefit or unacceptable toxicity. [DILC 2020, abstract LBO10]

In terms of all-cause adverse events (AEs), the main toxicities observed with the combo regimen were hypertension, proteinuria, diarrhoea, and pyrexia. As per Ducreux, these were consistent with the regimen’s global safety profile, and “were fairly manageable. Other than hypertension, most high-grade AEs were infrequent.” Use of sorafenib, on the other hand, led to higher incidences of diarrhoea and palmar-plantar erythrodysesthesia (PPE), which have been the main safety issues associated with sorafenib.

Regarding serious bleeding events (all grade), the combo regimen vs sorafenib was associated with higher rates of gastrointestinal (2.4 percent vs 1.9 percent) and oesophageal varices haemorrhage (2.4 percent vs 0.6 percent). Nonetheless, these increases were “little”, noted Ducreux. Also, the GI bleeding rate with the combo regimen was lower than the previously reported 7 percent. [N Engl J Med 2020;382:1894-1905]

Moreover, other bleeding events (ie, epistaxis, haematuria, gingival bleeding) “were not severe and were very easy to manage”, noted Ducreux. “[As such,] there is no problem concerning the risk of bleeding [with the combo regimen].”

The fraction of participants who discontinued the combo regimen was lower than those on sorafenib (7 percent vs 10.3 percent). “[This] means that it is possible to continue this combination treatment for a longer period of time, sometimes with only atezolizumab or bevacizumab,” Ducreux pointed out.

More patients on the combo regimen vs sorafenib had AEs of special interest requiring corticosteroids (12.2 percent vs 3.2 percent [any grade] and 8.5 percent vs 2.6 percent [grade 3/4]). Moreover, four combo regimen recipients required immunosuppressive treatments other than corticosteroids.

Taken together, the increased toxicity with the combo regimen vs sorafenib may be attributed to the longer duration of treatment with the former vs the latter (median, 7.4 [atezolizumab] and 6.9 months [bevacizumab] vs 2.8 months [sorafenib]). Despite the longer treatment exposure, the combo regimen was generally well-tolerated, and the toxicities were manageable, noted Ducreux.

“Based on the strong efficacy results and the patient-reported outcomes from IMbrave150, as well as [this] in-depth safety evaluation, atezolizumab-bevacizumab should be considered a practice-changing treatment for patients with unresectable HCC who have not received prior systemic treatment,” concluded Ducreux.

 

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Most Read Articles
04 Oct 2020
Obesity does not appear to be strongly correlated with an increased risk for febrile neutropaenia during levofloxacin prophylaxis in patients with haematological malignancies receiving intermediate-risk myelosuppressive chemotherapy, suggests a study.
Roshini Claire Anthony, 25 Nov 2020

Initiation or switch to the single-tablet regimen of bictegravir/emtricitabine/tenofovir alafenamide (TAF) led to low HIV-1 RNA viral load in people living with HIV (PLHIV), according to the BICSTaR study presented at HIV Glasgow 2020.

09 Nov 2020
Use of corticosteroids appears to be an effective treatment for paediatric drug reaction with eosinophilia and systemic symptoms (DRESS), suggest the results of a recent study. In severe cases, corticosteroids used in conjunction with intravenous immunoglobulin result in fast clinical improvement.
Stephen Padilla, 10 Nov 2020
Patients with chronic obstructive pulmonary disease (COPD) seem to benefit from using chlorhexidine oral rinses twice daily as shown by the reduction in oral and sputum microbiota alpha diversity and by clinically significant improvements in COPD symptoms, according to a study presented at ID Week 2020.