Shaobo Zhang,1,2 Jiabei Wang,1 Zebin Zhu,1 Peng Ji,2 Yanli Wang,2 Kun Cheng,2 Björn Nashan,1 Lianxin Liu,1 Shugeng Zhang1 

1Department of Liver Transplantation, The First Affiliated Hospital of University of Science and Technology of China, Hefei, People’s Republic of China; 2Graduate School of Bengbu Medical University, Bengbu, People’s Republic of China

Correspondence: Shugeng Zhang, Department of Liver Transplantation, the First Affiliated Hospital of University of Science and Technology of China, Hefei, People’s Republic of China, Email zsg0517@ustc.edu.cn Lianxin Liu, Department of Liver Transplantation, the First Affiliated Hospital of University of Science and Technology of China, Hefei, People’s Republic of China, Email liulx@ustc.edu.cn

Purpose: To evaluate the efficacy and safety of different doses of bevacizumab combined with atezolizumab in patients with unresectable hepatocellular carcinoma.
Methods: A retrospective analysis was conducted on clinical data from patients receiving Atezo-Bev therapy at our institution. Patients were stratified into standard-dose (SD) and low-dose (LD) groups based on bevacizumab dosage. Comparative analyses evaluated antitumor efficacy and adverse events (AEs) incidence.
Results: A total of 63 patients were included (SD group: n=32; LD group: n=31). Baseline characteristics showed no significant differences between the groups. Median overall survival (OS) was 22.0 months in the SD group and 19.3 months in the LD group, while median progression-free survival (PFS) was 8.0 months and 6.9 months, respectively. No statistically significant differences were observed in OS or PFS between the two groups (P=0.276 and P=0.297, respectively). However, the incidence of bevacizumab-related AEs was lower in the LD group compared to the SD group.
Conclusion: Compared to low-dose bevacizumab combined with atezolizumab, the standard-dose regimen did not demonstrate significant superiority in OS or PFS. Additionally, the low-dose combination may lead to fewer AEs.

Keywords: hepatocellular carcinoma, bevacizumab, atezolizumab, efficacy, adverse events