Atezolizumab (PD-L1) + bevacizumab (VEGF) in HCC: “on-target” TRAEs (renal/vascular/skin) track with longer OS

Atezolizumab is an anti–PD-L1 antibody and bevacizumab is an anti-VEGF antibody; this post hoc exploratory analysis pooled patients from IMbrave150 (NCT03434379) and GO30140 (NCT02715531) to test whether adverse events (AEs) relate to outcomes in unresectable HCC treated first-line with atezolizumab+bevacizumab (Atez/Bev). In a 3‑month landmark among patients completing ≥3 months of Atez/Bev (n=332 of 435), treatment-related renal/urinary, mild vascular, and skin/subcutaneous AEs correlated with improved OS (mOS not reached vs 20.2 months; p<0.001, p<0.001, and p=0.014, respectively), with a dose–response pattern for “beneficial AE types” (1 type: HR 0.56; ≥2 types: HR 0.20). Conversely, metabolism/nutrition AEs (HR 1.58), hepatobiliary AEs (HR 1.67), and grade 3+ GI AEs (HR 2.09) correlated with worse OS—important because IMbrave150’s overall benchmark for Atez/Bev in this setting is mOS ~19.2 months vs sorafenib 13.4 months (HR 0.66), so these AE-defined subgroups may help interpret who is doing better/worse on today’s SOC rather than defining a new SOC.