Dr Finn on Tiragolumab Plus Atezolizumab and Bevacizumab in HCC

“The triplet does not add any new toxicities [besides] an increased frequency of rash and itching compared with atezolizumab and bevacizumab alone.”

Richard S. Finn, MD, a professor in the Department of Medicine, Division of Hematology/Oncology, at the Geffen School of Medicine of UCLA, discussed the background of the phase 1/2 MORPHEUS-Liver trial (NCT04524871) of tiragolumab in combination with atezolizumab (Tecentriq) and bevacizumab (Avastin) for the treatment of patients with unresectable locally advanced or metastatic hepatocellular carcinoma (HCC).

MORPHEUS-Liver evaluated novel triplet regimens in the frontline setting, Finn began. All the triplets included an atezolizumab/bevacizumab backbone, he added. Atezolizumab plus bevacizumab has been approved by the FDA for 5 years and is now also available globally and is among the most active regimens for patients with advanced HCC based on overall survival (OS), progression-free survival (PFS), and objective response rate (ORR), he noted.

Tiragolumab is an anti-TIGIT antibody that emerged as a promising combination component based on prior data from MORPHEUS-Liver, Finn said. Investigators then compared tiragolumab plus atezolizumab and bevacizumab vs atezolizumab and bevacizumab, he added. The study included 40 patients in the triplet arm and 18 in the doublet arm, he said.

Prior data published in Lancet Oncology demonstrated that the confirmed ORR per RECIST 1.1 criteria in the triplet arm (n = 41) was 43% (95% CI, 27%-59%) compared with 11% (95% CI, 1%-35%) in the doublet arm, Finn explained. The median PFS was 12.3 months (95% CI, 8.2-17.5) vs 4.2 months (95% CI, 1.6-7.4), respectively (HR, 0.51; 95% CI, 0.27-0.95), he added. In terms of safety, the triplet did not add any additional toxicities beyond increased frequencies of rash and itching, he noted.

Finn noted that at the time of the prior publication, OS data were not yet mature. Updated findings from MORPHEUS-Liver presented at the 2025 ESMO Gastrointestinal Cancers Congress revealed that the investigator-assessed median OS was 26.6 months (95% CI, 22.6-40.6) in the triplet arm compared with 16.0 months (95% CI, 7.5-18.5) in the doublet arm (HR, 0.55; 95% CI 0.29-1.04).