Reviewing the IMbrave150 Trial of Atezolizumab Plus Bevacizumab in Unresectable HCC

Zahra Hamedi, MD, presents the IMbrave150 trial for Team Chicago Hot Dog, reviewing the global phase 3 study of atezolizumab plus bevacizumab versus sorafenib in unresectable hepatocellular carcinoma (HCC). Hamedi describes the treatment-naive population with Child-Pugh A liver function and the requirement for endoscopy within 6 months, noting that patients with untreated high-risk varices were excluded. She walks through the co-primary endpoints and the updated analysis showing improved median overall survival and progression-free survival with atezolizumab plus bevacizumab, along with a higher objective response rate. Hamedi reviews the safety profile, including hypertension as a key bevacizumab-associated toxicity, and discusses post hoc outcomes by ALBI grade, where grade 1 patients derived clear benefit while grade 2 patients showed less separation. She closes by emphasizing liver-function deterioration as an important endpoint, reinforcing that objective markers such as ALBI grade should inform patient selection in advanced HCC.