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The approval was based on results from the IMbrave150 study, published in the New England Journal of Medicine. Patients treated with the atezolizumab–bevacizumab combination lived significantly longer than those treated with sorafenib and also experienced longer periods without cancer progression. Dr. Richard Finn of UCLA called it "a major advance for patients" and "a huge step forward" that clinicians treating HCC had long been waiting for.
Dr. Robin Kelley of the UCSF Helen Diller Family Comprehensive Cancer Center noted that not only was the combination more effective, but it also produced "strikingly better patient-reported outcomes," including improved physical function. According to Dr. Tim Greten of the NCI, the combination regimen is likely to replace sorafenib as the standard first-line treatment for eligible patients with advanced HCC.
Overall, patients appeared to tolerate both medications well. While the combination group had a slightly higher rate of serious adverse effects (38% versus 31% in the sorafenib group), fewer patients in the combination group needed to pause or reduce their dose due to side effects (50% versus 61%). Only 7% of patients stopped both medications entirely due to adverse effects.
Bleeding is a notable concern given bevacizumab's effect on blood vessels, compounded by the fact that liver cancer itself can cause low platelet counts and other bleeding risk factors. Significant bleeding occurred in 6% of patients in both groups. Experts recommend that patients undergo standard screening for bleeding risk factors before starting the combination, and that alternative therapies be considered for those at high risk of bleeding.
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About Sai Sree
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