Michael S. Lee, MD, assistant professor of medicine, Department of Molecular Therapeutics, UNC Lineberger Comprehensive Cancer Center, discusses trial data evaluating the combination of atezolizumab (Tecentriq) and bevacizumab (Avastin) in patients with unresectable hepatocellular carcinoma (HCC).

The combination of atezolizumab and bevacizumab led to clinically meaningful responses and a statistically significant improvement in progression-free survival (PFS) among patients with unresectable HCC, according to data from 2 trials that were presented at the 2019 ESMO Congress.

According to the findings from the single-arm trial, in which safety and objective response served as coprimary endpoints, the objective response rate was 36% and the complete response rate was 12%. Moreover, the disease-control rate was 71%, adds Lee. In the randomized trial, which evaluated atezolizumab alone versus atezolizumab in combination with bevacizumab, PFS and safety served as coprimary endpoints. Notably, patients who received the combination experienced a 45% reduction in the risk of progression or death versus atezolizumab monotherapy (HR, 0.55; 

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Michael S. Lee, MD, discusses trial data evaluating the combination of atezolizumab (Tecentriq) and bevacizumab (Avastin) in unresectable hepatocellular carcinoma.

Dr. Lee on Trial Data Evaluating the Atezolizumab/Bevacizumab in Unresectable HCC

Michael S. Lee, MD, assistant professor of medicine, Department of Molecular Therapeutics, UNC Lineberger Comprehensive Cancer Center, discusses the treatment of patients with newly diagnosed metastatic colorectal cancer (mCRC).

A lot of the ongoing research in this setting is centered around personalizing care, Lee says. This is really dependent on the biologic agent that is chosen to be paired with frontline chemotherapy. Recent data have shown that chemotherapy backbones of FOLFOX and FOLFIRI are equivalent. A biologic agent, however, should be chosen based on the patient’s underlying mutation status, says Lee.

 mutations are not eligible to receive an EGFR antibody, so they will receive bevacizumab (Avastin) if given a biologic. For patients with 

 mutations, it is still relatively unclear if bevacizumab is more effective than an EGFR antibody like cetuximab (Erbitux) with the chemotherapy backbone. However, ongoing studies are looking at this issue, says Lee.

Michael S. Lee, MD, assistant professor of medicine, Department of Molecular Therapeutics, UNC Lineberger Comprehensive Cancer Center, discusses the treatment of patients with newly diagnosed metastatic colorectal cancer.

Dr. Lee on Treatment of Newly Diagnosed mCRC

Michael S. Lee, MD, assistant professor of medicine, Department of Molecular Therapeutics, UNC Lineberger Comprehensive Cancer Center, discusses tailoring treatment to tumor sidedness in patients with metastatic colorectal cancer (mCRC).

Primary tumor sidedness has emerged as a very important clinical feature utilized to drive treatment decisions. According to national consensus guidelines, patients with right-sided tumors, even if they are 

 wild-type, should not be treated with anti—EGFR therapy as part of their frontline regimen. If a biologic is given, the patient should receive chemotherapy with bevacizumab (Avastin), Lee says.

On the other hand, for patients with a left-sided tumor, recent data do support a survival benefit with adding an EGFR antibody like cetuximab (Erbitux) to the chemotherapy backbone. In the United States, it is reasonable to talk about starting with an alternative approach like bevacizumab and chemotherapy. Further, it is important to tailor treatment based on toxicity concerns and side effect profiles, says Lee.

Michael S. Lee, MD, assistant professor of medicine, Department of Molecular Therapeutics, UNC Lineberger Comprehensive Cancer Center, discusses tailoring treatment to tumor sidedness in patients with metastatic colorectal cancer.

Michael S. Lee, MD

Articles

Dr. Lee on Trial Data Evaluating the Atezolizumab/Bevacizumab in Unresectable HCC

Dr. Lee on Treatment of Newly Diagnosed mCRC

Dr. Lee on Tailoring Treatment to Tumor Sidedness in mCRC