Dr. Somer on the Impact of the IMbrave150 Trial on the HCC Paradigm

Bradley G. Somer, MD, a medical oncologist, head of strategic expansion/development in the West Cancer Center Research Program, and president of West Cancer Center; an associate professor in the Department of Hematology and Medical Oncology at the University of Tennessee Health Science Center; and head of strategic expansion/development with the West Cancer Center Research Program, discusses the impact of the phase 3 IMbrave150 trial on the treatment of patients with unresectable hepatocellular carcinoma (HCC).

The prior standard for HCC treatment had been oral TKIs, specifically sorafenib (Nexavar), which was approved by the FDA in 2008, says Somer. There was not much change until 2018, when lenvatinib (Lenvima) received regulatory approval based on data from a noninferiority study. 

In the IMbrave150 study, investigators compared sorafenib with bevacizumab (Avastin) plus atezolizumab (Tecentriq). This trial was powered for overall survival (OS) and progression-free survival, although safety was also examined. A clear OS benefit was observed with the combination, which reduced the risk of death by 42%, says Somer.

Additionally, the safety profile of the regimen was found to very tolerable. VEGF inhibitors tend to have some quality-of-life (QOL)–related adverse effects, according to Somer. These toxicities can include hand-foot syndrome, asthenia, diarrhea, and others, although these are not reported as often with atezolizumab plus bevacizumab. For the patients who are without a contraindication, this represents a new standard of care in the frontline setting, concludes Somer.