Outcomes of atezolizumab and bevacizumab for hepatocellular carcinoma: Does age matter?

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the fourth most frequent cause of cancer-related deaths in the world.1 Although curative treatment modalities of HCC, including liver transplantation, surgical resection and local ablation therapies, could provide acceptable outcomes, around 50%–60% of patients with HCC will receive systemic therapies eventually.2, 3 Until recently, tyrosine kinase inhibitors sorafenib and lenvatinib have been the mainstay treatment of unresectable HCC, with median overall survival (OS) durations of 11–14 months.4, 5 The combination of atezolizumab and bevacizumab is the first treatment regimen that has been shown to improve OS over sorafenib in patients with advanced-stage HCC, with the updated median OS duration of 19.2 months.6, 7 One recent real-world data from 11 centres in Korea further showed that the treatment efficacy and safety of atezolizumab and bevacizumab combination therapy for HCC were similar to that was reported in the prospective phase 3 clinical trial.8 Hence, atezolizumab plus bevacizumab has been recommended as the first-line standard of care for patients with unresectable HCC currently.2