BackgroundAtezolizumab-Bevacizumab is one of the standard treatment for unresectable hepatocellular carcinoma patients. However, clinical data on the effectiveness of this regimen specifically in patients with HBV-related unresectable hepatocellular carcinoma remain limited.ObjectivesTo evaluate survival outcomes and identify prognostic factors in HBV-infected unresectable HCC patients treated with Atezolizumab-Bevacizumab as first line systemic therapy.MethodsA prospective combining retrospective cohort study, conducted on unresectable HCC patients with HBV infection, treated with Atezolizumab-Bevacizumab as the first-line systemic therapy at 3 major cancer-specialized hospitals in Northern Vietnam from June 2020 to August 2024.ResultsTotally 97 patients were included, the median age was 57 years, 89.4% were male. After a median follow-up of 11.1 (95% CI: 9.8-13.2) months, the median progression-free survival (mPFS) was 4.3 (95% CI: 3.4-5.2) months, and the median overall survival (mOS) was 20 (95% CI: 11.1-28.9) months. Multivariate analysis showed that Child-Pugh score A 6 points and B 7-8 points (HR: 2.0, P = 0.009 and HR: 4.5, P = 0.029), liver tumor size ≥80 mm (HR: 1.7, P = 0.037), and distant metastasis (HR: 1.9, P = 0.019), were independent predictors of PFS. Independent predictors of OS included ECOG - PS 1 (HR: 1.8, P = 0.047), ALBI grade 2-3 (HR: 2.0, P = 0.033), and NLR >2.9 (HR: 2.0, P = 0.023).ConclusionThe Atezolizumab-Bevacizumab regimen has shown favorable effectiveness as first-line treatment for unresectable HBV-related HCC in Vietnam. These findings provide real-world evidence to support policymakers in developing treatment strategies in HBV-endemic regions and guide future research on optimizing HCC management.
Keywords: HBV; atezolizumab; bevacizumab; hepatocellular carcinoma (HCC); prognostic factors; survival outcomes.