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Comparative effectiveness of two first-line, ICI-based regimens for advanced HCC: a target trial emulation using an electronic medical record network - PubMed

3 months ago
  • #immune checkpoint inhibitors
  • #hepatocellular carcinoma
  • #real-world evidence
  • Comparative effectiveness of atezolizumab plus bevacizumab (Atezo+Bev) and tremelimumab plus durvalumab (Treme+Dur) as first-line therapies for advanced hepatocellular carcinoma (HCC).
  • Study used a target trial emulation approach with real-world data from the TriNetX Research Network, including 640 patients per group after propensity score matching.
  • Primary outcome was overall survival (OS), with secondary outcomes including 1- or 2-year OS and immune-related adverse events (irAEs).
  • One-year OS was higher in the Atezo+Bev group (61% vs 55%), but two-year OS and overall OS showed no significant differences between the two regimens.
  • Hepatic irAEs occurred later in the Atezo+Bev group, while respiratory irAEs appeared earlier in the Treme+Dur group.
  • Both regimens demonstrated broadly comparable long-term OS rates, but Treme+Dur may require careful monitoring for early-onset hepatic dysfunction and respiratory irAEs.