Real-World Outcomes With Atezolizumab Plus Bevacizumab vs Durvalumab-Based Therapy

Midhun Malla, MD, presents real-world data for Team Deep-Dish Pizza, reviewing a multicenter retrospective study comparing frontline atezolizumab plus bevacizumab with durvalumab-based therapy in advanced hepatocellular carcinoma (HCC). Malla describes the electronic health record analysis across six US institutions and the baseline differences between cohorts, noting that patients receiving durvalumab-based therapy had higher rates of cirrhosis and more advanced BCLC stage. He walks through the central finding that median overall survival was similar between regimens, with comparable objective response and disease control rates despite the sicker durvalumab-treated population. Malla emphasizes that the study included patients with impaired liver function who are often underrepresented in pivotal trials, while cautioning that confounding remains possible in retrospective data. He also reviews how Child-Pugh class remained a strong prognostic variable, with markedly worse outcomes in Child-Pugh B and C disease. The presentation supports both regimens as reasonable frontline options in real-world advanced HCC practice.