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@article{Manfredi:2025:10.1016/j.jhepr.2025.101431,
author = {Manfredi, G and Fulgenzi, C and Celsa, C and Stefanini, B and D'Alessio, A and Pinter, M and Scheiner, B and Awosika, N and Brunetti, L and Lombardi, P and Latchford, C and Lee, P and Huang, Y and Lin, C and Dalbeni, A and Vogel, A and Galle, PR and Kudo, M and Rimassa, L and Chon, HJ and Cabibbo, G and Piscaglia, F and Camma, C and Pillai, A and Pirisi, M and Singal, A and Pinato, D},
doi = {10.1016/j.jhepr.2025.101431},
journal = {JHEP Reports},
title = {Efficacy of atezolizumab plus bevacizumab for unresectable HCC: systematic review and metanalysis of real-world evidence},
url = {http://dx.doi.org/10.1016/j.jhepr.2025.101431},
volume = {7},
year = {2025}
}
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TY  - JOUR
AB  - Background and AimsAtezolizumab plus bevacizumab (A+B) is a standard of care treatment in unresectable hepatocellular carcinoma (uHCC). Verification of its effectiveness outside clinical trials is an area of unmet need, especially in estimating long-term survival outcomes.MethodsWe conducted a systematic review and metanalysis of MEDLINE, Embase, Cochrane libraries to evaluate therapy outcomes in patients treated with frontline A+B for uHCC outside trials. Pooled estimates of overall survival (OS) and progression-free survival (PFS) at 6 and 12 months were calculated from individual patient-level data using random-effects analysis.ResultsOf 2179 patients selected from 12 cohorts, 80.5% were male, median age was 66 years (IQR 61.6-73.0), 61.6% had advanced-stage HCC, and 83.6% were Child-Pugh (CP) class A. Pooled 6- and 12-month OS were 82% (95%CI 76-86%; I2=80%) and 65% (95%CI 60-70%; I2=66%). Median OS of patients with CP-A liver function was 20.9 months (95%CI 15.7-20.9), consistent with IMbrave150 estimates (19.2 months, 95%CI 17.0-23.7, p=0.58). Pooled PFS at 6 and 12 months were 57% (95%CI 53-61%; I2=49%) and 35% (95%CI 31-39%, I2=60%). Among patients with longer follow-up, the OS (n=1783) and PFS (n=959) rates were 52% (95%CI 46-58; I2=90%) and 26% (95%CI 17-37; I2=91%) at 18 months, respectively. At 24-months, OS (n=1556) rate was 39% (95%CI 31-49; I2=90%) and PFS (n=732) rate was 25% (95%CI 12-45; I2=95%).ConclusionsThe effectiveness of A+B after registration mirrors its efficacy estimates from clinical trial datasets. Long-term survival at 24 months can be achieved in up to 39% of patients with uHCC treated with A+B in routine clinical practice.Impact and implicationsThis study provides real-world evidence supporting the long-term efficacy of atezolizumab plus bevacizumab (A+B) for unresectable hepatocellular carcinoma (uHCC), showing survival outcomes similar to clinical trials. These findings are important for clinicians in supporting A+B as a frontline t
AU  - Manfredi,G
AU  - Fulgenzi,C
AU  - Celsa,C
AU  - Stefanini,B
AU  - D'Alessio,A
AU  - Pinter,M
AU  - Scheiner,B
AU  - Awosika,N
AU  - Brunetti,L
AU  - Lombardi,P
AU  - Latchford,C
AU  - Lee,P
AU  - Huang,Y
AU  - Lin,C
AU  - Dalbeni,A
AU  - Vogel,A
AU  - Galle,PR
AU  - Kudo,M
AU  - Rimassa,L
AU  - Chon,HJ
AU  - Cabibbo,G
AU  - Piscaglia,F
AU  - Camma,C
AU  - Pillai,A
AU  - Pirisi,M
AU  - Singal,A
AU  - Pinato,D
DO  - 10.1016/j.jhepr.2025.101431
PY  - 2025///
SN  - 2589-5559
TI  - Efficacy of atezolizumab plus bevacizumab for unresectable HCC: systematic review and metanalysis of real-world evidence
T2  - JHEP Reports
UR  - http://dx.doi.org/10.1016/j.jhepr.2025.101431
UR  - https://www.sciencedirect.com/science/article/pii/S2589555925001089
VL  - 7
ER  -
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