Dr Li on the Casdozokitug/Atezolizumab/Bevacizumab in Unresectable HCC

“[These findings] beg the question: Are these patients potentially in ongoing remission from their cancer? For an aggressive tumor like HCC, I think [that] is incredibly promising for the future.”

Daneng Li, MD, associate professor, Department of Medical Oncology & Therapeutics Research, and co-director, Neuroendocrine Tumor Program, City of Hope, discusses findings from a phase 2 trial (NCT05359861) evaluating casdozokitug (CHS-388) in combination with atezolizumab (Tecentriq) and bevacizumab (Avastin) in patients with unresectable, locally advanced, or metastatic hepatocellular carcinoma (HCC).

This open-label lead-in trial enrolled 30 patients with frontline unresectable or metastatic HCC with at least 1 measurable lesion. The combination of casdozokitug, atezolizumab, and bevacizumab demonstrated promising efficacy in patients with HCC, Li begins. The overall response rate (ORR) was 37.9% per RECIST 1.1 criteria and 42.9% per modified RECIST (mRECIST) criteria. Both ORRs exceed those historically observed with current standard-of-care therapies for HCC, Li explains.

Notably, the complete response (CR) rate was 17.2% per both RECIST 1.1 and mRECIST criteria, which is an increase from the CR rates historically seen with first-line HCC treatments, which range from approximately 2% to 8%, Li says. This finding suggests a significantly higher rate of complete tumor regression with casdozokitug plus atezolizumab and bevacizumab compared with existing therapeutic options, he states.

Furthermore, many of these CRs have persisted for multiple years, Li reports. This raises the question of whether some patients may achieve long-term remission with casdozokitug plus atezolizumab and bevacizumab, Li says, adding that which is a particularly encouraging outlook for a typically aggressive malignancy like HCC.

Moreover, the median progression-free survival (PFS) per RECIST 1.1 criteria in the response-evaluable population (n = 29) was 8.1 months (95% CI, 1.9-13.6). The 6-, 12-, and 18-month PFS rates were 58.6% (95% CI, 38.8%-74.0%), 36.1% (95% CI, 19.0%-53.6%), and 27.1% (95% CI, 11.9%-44.9%), respectively.