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ASCO GI: New drug combinations maintain quality of life for patients with colorectal and liver cancers

Patient-reported outcomes from two large studies show that quality of life is maintained longer with newer drug combinations compared with standard of care for the treatment of patients with a specific type of colorectal cancer and unresectable hepatocellular carcinoma.

The results will be presented at the 2020 Gastrointestinal Cancers Symposium, taking place January 23-25 in San Francisco, California.

Quality of life maintained for patients treated With atezolizumab and bevacizumab for unresectable hepatocellular carcinoma

The combination of atezolizumab and bevacizumab delayed declines in quality of life in a study comparing the two-drug treatment with sorafenib (the standard of care) for patients with unresectable hepatocellular carcinoma (HCC).

Atezolizumab is a programmed cell death ligand 1 (PD-L1) inhibitor; bevacizumab is a vascular endothelial growth factor (VEGF) inhibitor.

“Because it reflects both the effects of disease and the side effects of treatment, sustained or improved quality of life is particularly important for patients,” said lead author Peter R. Galle, MD, PhD, of the University Medical Center in Mainz, Germany. “Patients with liver cancer are typically more fragile and frail than others. Toxicity of the treatments can be much more serious for these patients, and their quality of life can decline quite quickly.”

The results come from the phase-III IMbrave 150 trial, which compared atezolizumab plus bevacizumab with sorafenib alone as a first-line treatment for patients with HCC who had not received prior systemic therapy.

The primary endpoint of overall survival was presented at the European Society for Medical Oncology (ESMO) Asia Congress in November 2019.

At that time, median overall survival had not yet been reached for atezolizumab plus bevacizumab compared with overall survival of 13.2 months for patients receiving sorafenib alone.

The overall response rate was 27% with atezolizumab plus bevacizumab and 12% for sorafenib.

At the Gastrointestinal Cancers Symposium, researchers will present patient-reported outcomes results from the study.

Time to deterioration, assessed by two validated patient-reported quality of life tools, was a prespecified secondary endpoint of the study.

Time to deterioration was defined as a decrease of 10 points from baseline in key patient-reported outcomes.

At baseline, every three weeks during therapy, and every three months after discontinuation of therapy, patients completed two questionnaires (one specific to HCC) to assess quality of life, physical functioning, and role functioning.

Questionnaire completion rates were about 92%.

Time to deterioration was a median of 11.2 months for the combination treatment compared with 3.6 months for sorafenib.

Declines in physical functioning were also delayed with the combination treatment, with a median delay of 13.1 months with atezolizumab and bevacizumab compared with 4.9 months for sorafenib.

Source: 2020 Gastointestinal Cancers Symposium



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