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The following is a summary of “Atezolizumab Plus Chemotherapy With or Without Bevacizumab in Advanced Biliary Tract Cancer: Clinical and Biomarker Data From the Randomized Phase II IMbrave151 Trial,” published in the October 2024 issue of Oncology by Macarulla et al.
Biliary tract cancers (BTCs) often exhibit an immunosuppressive tumor microenvironment, resulting in poor responses to programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors.
Researchers conducted a prospective study assessing the effectiveness of atezolizumab in combination with chemotherapy, with or without bevacizumab, in patients with advanced BTC.
They enrolled 162 patients with untreated advanced BTC and randomly assigned them to receive either atezolizumab (1,200 mg) plus bevacizumab (15 mg/kg) or atezolizumab plus placebo every 3 weeks, in addition to cisplatin (25 mg/m2) and gemcitabine (1,000 mg/m2) on days 1 and 8 for up to 8 cycles.
The results showed the median progression-free survival (PFS) was 7.9 months in the placebo arm (stratified HR, 0.67 [95% CI, 0.46 to 0.95]) and 8.3 months in the bevacizumab arm. Median overall survival (OS) was 14.9 months in the bevacizumab arm and 14.6 months in the placebo arm (stratified HR, 0.97 [95% CI, 0.64 to 1.47]). High vascular endothelial growth factor A (VEGFA) gene expression was linked with improved PFS in the bevacizumab arm (HR, 0.44 [95% CI, 0.23 to 0.83]).
They concluded that adding bevacizumab to atezolizumab and chemotherapy provided a modest improvement in PFS for patients with advanced BTC, and high VEGFA expression potentially served as a predictive biomarker.
Source: ascopubs.org/doi/10.1200/JCO.24.00337
