In a new study, researchers have identified a first-line treatment that strongly improves survival for people with hepatocellular carcinoma, the most common type of liver cancer.
They found that the combination of atezolizumab, an immunotherapy drug that boosts the body’s natural defenses, and bevacizumab, an anti-angiogenesis drug that inhibits the growth of tumors’ blood vessels, improved overall survival and reduced the risk of death by 42%.
It also decreased the risk of the disease worsening by 41%, and the percentage of patients whose cancer shrank or disappeared more than doubled.
The combination is currently being reviewed for approval under the U.S. Food and Drug Administration’s Real-Time Oncology Review pilot program.
The research was conducted by a team at UCLA.
Currently, people diagnosed with advanced liver cancer have limited treatment options, and the prognosis for survival is poor.
Clinical treatment advancements have been few and far between. Until now, no new first-line therapy has been shown to improve survival since the drug sorafenib was approved in 2007.
Both atezolizumab and bevacizumab are monoclonal antibodies—specialized drugs that attach themselves to specific proteins and disable them—and they have already been used alone and in combination with other therapies to treat other cancers.
Atezolizumab targets a protein produced by cancer cells that shuts down the immune system’s infection-fighting T cells, preventing them from attacking cancer.
Bevacizumab interferes with a tumor’s blood supply, preventing cancer from growing and spreading through the body.
The team says that by using these two drugs with different mechanisms of action together, they have increased the number of patients who respond to this treatment and have increased the duration of these responses as compared to the standard treatment, sorafenib.
The study included 501 people, aged 18 and over, from multiple centers worldwide, who had advanced metastatic or unresectable hepatocellular carcinoma.
Two-thirds of participants were randomly assigned to receive the atezolizumab and bevacizumab combination, while one-third received sorafenib.
Twelve months after the start of treatment, the rate of survival with the combination was 67.2%, compared with 54.6% for the group on sorafenib.
The team says the therapy is a real game-changer for people diagnosed with this aggressive disease.
Doctors now have a new therapy that not only improves survival for people with the disease, which is very challenging to treat, but that helps them live longer while maintaining a high quality of life.
The lead author of the study is Dr. Richard S. Finn, a professor of medicine at the David Geffen School of Medicine.
The study is published in the New England Journal of Medicine.
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