{"doi":"10.1056/nejmoa1915745","title":"Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma","abstract":"<h4>Background</h4>The combination of atezolizumab and bevacizumab showed encouraging antitumor activity and safety in a phase 1b trial involving patients with unresectable hepatocellular carcinoma.<h4>Methods</h4>In a global, open-label, phase 3 trial, patients with unresectable hepatocellular carcinoma who had not previously received systemic treatment were randomly assigned in a 2:1 ratio to receive either atezolizumab plus bevacizumab or sorafenib until unacceptable toxic effects occurred or there was a loss of clinical benefit. The coprimary end points were overall survival and progression-free survival in the intention-to-treat population, as assessed at an independent review facility according to Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1).<h4>Results</h4>The intention-to-treat population included 336 patients in the atezolizumab-bevacizumab group and 165 patients in the sorafenib group. At the time of the primary analysis (August 29, 2019), the hazard ratio for death with atezolizumab-bevacizumab as compared with sorafenib was 0.58 (95% confidence interval [CI], 0.42 to 0.79; P<0.001). Overall survival at 12 months was 67.2% (95% CI, 61.3 to 73.1) with atezolizumab-bevacizumab and 54.6% (95% CI, 45.2 to 64.0) with sorafenib. Median progression-free survival was 6.8 months (95% CI, 5.7 to 8.3) and 4.3 months (95% CI, 4.0 to 5.6) in the respective groups (hazard ratio for disease progression or death, 0.59; 95% CI, 0.47 to 0.76; P<0.001). Grade 3 or 4 adverse events occurred in 56.5% of 329 patients who received at least one dose of atezolizumab-bevacizumab and in 55.1% of 156 patients who received at least one dose of sorafenib. Grade 3 or 4 hypertension occurred in 15.2% of patients in the atezolizumab-bevacizumab group; however, other high-grade toxic effects were infrequent.<h4>Conclusions</h4>In patients with unresectable hepatocellular carcinoma, atezolizumab combined with bevacizumab resulted in better overall and progression-free survival outcomes than sorafenib. (Funded by F. Hoffmann-La Roche/Genentech; ClinicalTrials.gov number, NCT03434379.).","journal":"New England Journal of Medicine","year":2020,"id":5487,"datarank":10.497447454737927,"base_score":8.857941984804711,"endowment":8.857941984804711,"self_citation_contribution":1.3286912977207068,"citation_network_contribution":9.168756157017219,"self_endowment_contribution":1.3286912977207068,"citer_contribution":9.168756157017219,"corpus_percentile":86.8,"corpus_rank":1808,"citation_count":7029,"citer_count":158,"citers_with_citation_signal":158,"citers_with_endowment":158,"datacite_reuse_total":0,"is_dataset":false,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-05-14","authors":[{"id":54188,"name":"Shukui Qin","orcid":"0000-0003-2289-1521","position":1,"is_corresponding":false},{"id":54189,"name":"Masafumi Ikeda","orcid":"0000-0002-4050-2086","position":2,"is_corresponding":false},{"id":54190,"name":"Peter R. 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Kaseb","orcid":"0000-0002-9491-0587","position":9,"is_corresponding":false},{"id":54197,"name":"Daneng Li","orcid":"0000-0001-5330-7522","position":10,"is_corresponding":false},{"id":54198,"name":"Wendy Verret","orcid":null,"position":11,"is_corresponding":false},{"id":54199,"name":"Derek-Zhen Xu","orcid":null,"position":12,"is_corresponding":false},{"id":54200,"name":"Sairy Hernandez","orcid":null,"position":13,"is_corresponding":false},{"id":54201,"name":"Juan Liu","orcid":"0000-0003-4333-9533","position":14,"is_corresponding":false},{"id":51813,"name":"Chen Huang","orcid":"0000-0001-8535-6417","position":15,"is_corresponding":false},{"id":54202,"name":"Sohail Mulla","orcid":null,"position":16,"is_corresponding":false},{"id":54203,"name":"Yulei Wang","orcid":"0000-0002-9057-9786","position":17,"is_corresponding":false},{"id":54204,"name":"Ho Yeong Lim","orcid":"0000-0001-9325-2300","position":18,"is_corresponding":false},{"id":54205,"name":"Andrew X. Zhu","orcid":"0000-0003-4873-5033","position":19,"is_corresponding":false},{"id":54206,"name":"Ann-Lii Cheng","orcid":null,"position":20,"is_corresponding":false},{"id":54207,"name":"Tae‐You Kim","orcid":null,"position":21,"is_corresponding":false},{"id":54208,"name":"В. В. Бредер","orcid":"0000-0002-6244-4294","position":22,"is_corresponding":false},{"id":54209,"name":"Ann‐Lii Cheng","orcid":"0000-0002-9152-6512","position":23,"is_corresponding":false},{"id":54187,"name":"Richard S. Finn","orcid":"0000-0003-2494-2126","position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-03-01T18:20:47.508186Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}