For patients with advanced or unresectable liver cancer who have not yet received treatment, the Italian Medicines Agency (Aifa) has made the use of immunotherapy with atezolizumab, in combination with the antiangiogenic drug bevacizumab, reimbursable. The combination, in fact, improves overall survival and progression-free survival of the disease compared to the standard of care. And, according to the patients themselves, it improves the quality of life. In addition, Atezolizumab may be used as monotherapy for the first-line treatment of metastatic non-small cell lung cancer with high PD-L1 expression.
Liver cancer: 6 out of 10 patients forced to go to several centers
by Tiziana Moriconi
December 15, 2021
Hepatocarcinoma
Hepatocellular carcinoma (HCC) represents one of the most aggressive forms of cancer with limited treatment options, and is a leading cause of cancer deaths worldwide, with 815,000 new diagnoses per year. HCC mainly develops in people suffering from cirrhosis due to chronic hepatitis (B or C) or alcohol abuse and typically occurs in advanced stages. The prognosis for unresectable forms of HCC is poor, with few systemic treatment options and a one-year survival rate of less than 50% from the time of diagnosis of the advanced form.
Liver: When the cancer is advanced, drugs are the only option
by Simone Valesini
07 January 2022
Combination therapy improves survival
For this reason, the approval of the atezolizumab-bevacizumab combination represents a milestone in the field of hepato-oncology. “After more than 10 years of immobility, a first-line treatment is finally available capable of prolonging the survival of patients with unresectable hepatocarcinoma, delicate patients who are not only suffering from cancer but also from liver dysfunction”, he said. commented Antonio Gasbarrini, Full Professor of Internal Medicine at the Catholic University of the Sacred Heart, Campus of Rome and Director of the Department of Medical and Surgical Sciences at the Agostino Gemelli IRCCS University Polyclinic Foundation.
The results of the IMbrave150 phase III clinical trial showed that the median survival of patients treated with the combination increased to 19.2 months, compared with 13.4 months of therapy with sorafenib, the previous standard of care. “It is the longest survival ever reported from a phase III study for the systemic treatment of unresectable hepatocellular carcinoma,” added Gasbarrini. “It represents a great step forward in the management of the patient suffering from hepatocellular cancer, which not only broadens the therapeutic horizon but guides us towards an ever greater personalization of therapy, for the benefit of the patient”.
Hepatocarcinoma, how to improve care, assistance and information
by Dario Rubino
27 Maggio 2022
Word to the patients
The atezolizumab-bevacizumab combination therapy also receives very positive feedback from patients, who in an analysis report benefits in terms of quality of life. The areas investigated include parameters such as the impact on work, on leisure time, on the ability to walk distances and on symptoms. The study found that patients treated with the combination atezolizumab and bevacizumab report significantly slower deterioration in quality of life and physical function than in the control arm. “These are the best data obtained so far in the history of hepatocarcinoma therapy and are comforting in terms of handling and tolerability with excellent results also on the quality of life of patients”, confirmed Fortunato Ciardiello, Professor of Medical Oncology and Vice Rector, University of the Studies of Campania Luigi Vanvitelli. “The interaction between immunotherapy and anti-angiogenic therapy represents the new therapeutic standard for the patient with hepatocarcinoma no longer treatable with locoregional treatments, but who requires systemic therapy”.
Atezolizumab also for lung cancer
Aifa also approved the extension of the use of atezolizumab as monotherapy for first-line treatment in metastatic stage non-small cell lung cancer with high PD-L1 expression. In the IMpower110 study, therapy significantly improved overall survival, with a 31% decrease in the risk of death and more than 60% of patients alive at 1 year. Thanks to this further extension of indication, atezolizumab represents today the first and only single-agent immunotherapy against lung cancer, available in three dosages, which allow administration every two, three or four weeks, thus making it available to doctors and patients greater flexibility in the management of treatment.