BUFFALO, NY - May 23, 2025 – A new #research paper was #published in Volume 16 of Oncotarget on May 19, 2025, titled “Immune-mediated adverse events following atezolizumab and bevacizumab in a multinational Latin American cohort of unresectable hepatocellular carcinoma."
The study, led by first authors Leonardo Gomes da Fonseca from Hospital das Clínicas, Universidade de São Paulo, Brazil, and Federico Piñero from Hospital Universitario Austral, Argentina, investigated how patients with advanced liver cancer in Latin America respond to a widely used immunotherapy combination. The researchers found that although a minority of patients developed immune-related side effects, these events did not significantly impact overall survival. Their findings highlight the importance of early recognition and careful management of such side effects in real-world clinical settings.
Liver cancer is a leading cause of cancer deaths worldwide, with limited treatment options for patients diagnosed at an advanced stage. Immunotherapy, particularly the combination of atezolizumab and bevacizumab, has become a standard approach. However, these treatments can sometimes trigger the body’s immune system to attack healthy organs, leading to what are called immune-related adverse events, or irAEs. Until now, little data existed on how frequently these events occur in Latin American patients and whether they impact treatment outcomes.
The researchers followed 99 patients from Argentina, Brazil, Chile, and Colombia, most of whom had cirrhosis or underlying liver disease. They received atezolizumab and bevacizumab for a median duration of six months. The researchers reported that only 18% of the patients experienced immune-related side effects, most commonly affecting the liver (hepatitis) and thyroid (thyroiditis). Most of these cases were mild or moderate, and half of them resolved completely within a month. Only eight patients needed treatment with steroids to control the immune response.
Importantly, the occurrence of immune-related side effects did not affect how long patients survived after starting treatment. The median survival was the same—18.5 months—for both those who experienced irAEs and those who did not. This result suggests that while irAEs require careful management, they may not reduce the overall benefits of immunotherapy.
Another significant finding was that patients with higher levels of alpha-fetoprotein (AFP), a protein often elevated in liver cancer, were more likely to experience these side effects. This information could help clinicians identify patients who need closer control during treatment.
“Notably, baseline alpha-fetoprotein (AFP) values ≥400 ng/ml were significantly associated with the development of irAEs.”
The study also points to key differences between clinical trial results and real-world experiences. While clinical trials report higher rates of side effects, this real-world data showed a lower incidence, possibly due to less intensive monitoring or differences in how side effects are documented in everyday practice.
In summary, this study highlights that patients require ongoing vigilance and individualized care when treating liver cancer with immunotherapy. It provides valuable information to healthcare providers in Latin America and other regions with similar patient populations, aiming to improve outcomes while minimizing risks.
DOI - https://doi.org/10.18632/oncotarget.28721
Correspondence to - Federico Piñero - fpinerof@cas.austral.edu.ar
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