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ESMO GI 2025 | Second-line treatment patterns after first-line immunotherapy in HCC
Julien Edeline, MD, PhD, Centre Eugene Marquis, Rennes, France, discusses real-world data from the CHIEF cohort, which assessed second-line treatment outcomes in advanced hepatocellular carcinoma (HCC) following first-line sorafenib or atezolizumab and bevacizumab. Access to second-line therapy was more limited post-immunotherapy, though survival with tyrosine kinase inhibitors remained comparable regardless of the first-line regimen. Immunotherapy rechallenge appeared promising, although potentially impacted by selection bias. This interview took place at the European Society for Medical Oncology (ESMO) Gastrointestinal Cancer 2025 Congress in Barcelona, Spain.
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Transcript
The chief cohort is a prospective cohort of patients treated with HEC. At this ESMO GI conference, we present results from patients treated with first-line systemic therapies. We compare outcomes from patients treated with sorafenib, Analyzed 200 patients with patients treated with atezolizumab, bevacizumab, 900 patients after approval of atezolizumab-bevacizumab. The main evolution we see is that we have a similar proportion of patients treated with second-line treatment in the atezolizumab-bevacizumab era as compared with the sorafenib era...
The chief cohort is a prospective cohort of patients treated with HEC. At this ESMO GI conference, we present results from patients treated with first-line systemic therapies. We compare outcomes from patients treated with sorafenib, Analyzed 200 patients with patients treated with atezolizumab, bevacizumab, 900 patients after approval of atezolizumab-bevacizumab. The main evolution we see is that we have a similar proportion of patients treated with second-line treatment in the atezolizumab-bevacizumab era as compared with the sorafenib era. It’s just under 50% of the population that progress that can be treated with second-line treatment. For the result of the second-line treatment, results are as expected. Outcomes under second-line TKI after atezolizumab-bevacizumab are very similar to outcomes after sorafenib. When we looked a bit more closely in the data, overall survival is similar to whatever the type of tyrosine kinase inhibitors we use as second line. However, there was a trend for improved PFS with the use of lenvatinib. We do have a small proportion of patients that were treated with immunotherapy after progression, after atezolizumab-bevacizumab. The outcomes of these very selected populations are very promising, but obviously this was a very selected population that had experienced response to atezolizumab-bevacizumab and had progression with quite a long delay after interruption of atezolizumab-bevacizumab. So the main message is we can use TKIs after atezolizumab-bevacizumab and we might study immunotherapy after atezolizumab-bevacizumab in a selected population.
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