Real‐World Outcomes of Atezolizumab–Bevacizumab in Hepatocellular Carcinoma: The Prospective French <scp>CHIEF</scp> Cohort
Manon Allaire, E.M. Thiam, G. Amaddeo, Mohamed Bouattour, Julien Edeline, Bleuenn Brusset, Marianne Ziol, P. Merle, Jean Frédéric Blanc, Thomas Uguen, Nathalie Ganne‐Carrié, Stéphane Cattan, Ghassan Riachi, V. Loustaud‐Ratti, Thomas Decaens, Christine Silvain, Jean Marie Péron, Aurore Baron, Georges‐Philippe Pageaux, Frédéric Oberti, Rodolphe Anty, Alina Pascale, Sylvain Manfrédi, Marc Bourlière, Jean Baptiste Nousbaum, Alexandra Heurgue, Isabelle Ollivier‐Hourmand, Marie Lequoy, J.-P. Bronowicki, Anne-Laure Villing, Gérard Ducournau, O. Ganry, Charlotte Costentin, Éric Nguyen-Khac
Abstract
BACKGROUND AND AIMS: Atezolizumab-Bevacizumab (AtezoBev) was the first immunotherapy approved for hepatocellular carcinoma (HCC) in France, with initial trials primarily involving patients with viral-related liver disease. This prospective study aimed to evaluate the efficacy of AtezoBev in a French HCC population predominantly affected by non-viral liver disease. METHODS: Data from 545 HCC patients treated with AtezoBev as first-line systemic therapy were collected from 32 French centres in the CHIEF cohort between July 2020 and January 2023. Kaplan-Meier analysis evaluated overall survival (OS) and progression-free survival (PFS), while log-rank tests assessed the impact of baseline characteristics. RESULTS: Median age was 69, with 81% Child-Pugh A and 19% Child-Pugh B. Liver disease was primarily alcohol-related (30%) or viral (16%), with mixed aetiology with at least alcohol consumption in 58%. At AtezoBev initiation, 72% of cases were treatment-naive, 31% were BCLC-B and 64% were BCLC-C. Median OS was 23.1 months, with a 12-month survival rate of 66%. OS was higher in BCLC-B patients (27.8 months) compared to BCLC-C (17.2 months, p = 0.0043) and in Child-Pugh A (26.4 months) compared to Child-Pugh B (10.6 months, p < 0.001). Median PFS was 5.2 months, with BCLC-B patients showing significantly longer PFS (6.7 months vs. 3.7 months for BCLC-C, p = 0.05). CONCLUSION: Real-world data from the CHIEF cohort demonstrate AtezoBev's effectiveness in a large French HCC population, showing survival and response rates comparable to the IMbrave150 study. These findings validate AtezoBev as effective in routine practice across diverse clinical profiles.