Jain A, Chitturi S, Peters G, Yip D. Atezolizumab and bevacizumab as first line therapy in advanced hepatocellular carcinoma: Practical considerations in routine clinical practice. World J Hepatol 2021; 13(9): 1132-1142 [PMID: 34630880 DOI: 10.4254/wjh.v13.i9.1132]
Corresponding Author of This Article
Ankit Jain, DM, DNB, FRACP, MBBS, MCLAM, MD, Staff Specialist, Department of Medical Oncology, The Canberra Hospital, Building 19, Level 5, Yamba Drive, Garran 2605, ACT, Australia. ankit.jain@anu.edu.au
Research Domain of This Article
Oncology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ankit Jain, Geoffrey Peters, Desmond Yip, Department of Medical Oncology, The Canberra Hospital, Garran 2605, ACT, Australia
Ankit Jain, Shivakumar Chitturi, Geoffrey Peters, Desmond Yip, ANU Medical School, Australian National University, Canberra 0200, ACT, Australia
Shivakumar Chitturi, Gastroenterology and Hepatology Unit, Canberra Hospital, Canberra 2605, ACT, Australia
Author contributions: Jain A and Yip D contributed concept and design, analysis and interpretation of data; Jain A, Chitturi S, Peters G and Yip D wrote the manuscript, and approved the final manuscript.
Conflict-of-interest statement: None of the authors report any conflict-of-interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ankit Jain, DM, DNB, FRACP, MBBS, MCLAM, MD, Staff Specialist, Department of Medical Oncology, The Canberra Hospital, Building 19, Level 5, Yamba Drive, Garran 2605, ACT, Australia. ankit.jain@anu.edu.au
Received: April 7, 2021 Peer-review started: April 7, 2021 First decision: June 15, 2021 Revised: June 27, 2021 Accepted: August 9, 2021 Article in press: August 9, 2021 Published online: September 27, 2021 Processing time: 167 Days and 11.7 Hours
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver cancer. For advanced HCC, sorafenib was considered the standard of care for more than ten years. Recently the atezolizumab and bevacizumab combination has become standard of care for these patients without contraindications to either immune checkpoint inhibitors or antiangiogenic therapy. We now review the practical aspects of the atezolizumab and bevacizumab combination, including current evidence, indications, contraindications, management of adverse events, sequencing of this combination, areas of current knowledge gaps and future areas of active clinical research of this combination for busy clinicians in clinical practice.
Core Tip: There are several articles about the role of atezolizumab and bevacizumab combination in advanced unresectable hepatocellular carcinoma. However, this mini review focuses on practical issues for clinicians using this combination in hepatocellular carcinoma (HCC) patients with focus on indications, data from recent trials, criteria for selection of appropriate patients for this combination, sequencing strategies, overlapping toxicities, issues with Child Pugh B cirrhosis patients, future role in adjuvant settings and dealing with special subsets of HCC population.
