A case of long-term therapy of hepatocellular carcinoma with atezolizumab and bevacizumab combination

Hepatocellular carcinoma is the most common primary malignant neoplasm of the liver, accounting for more than 90% of cases. Before the introduction of targeted therapy, there were virtually no options for the treatment of unresectable HCC. Currently, sorafenib and lenvatinib are registered as first-line therapy for unresectable HCC. The introduction of the combination of atezolizumab and bevacizumab has significantly improved the results of HCC treatment. In the IMbrave 150 study, the median OS was 19.2 months in the atezolizumab and bevacizumab group and 13.4 months in the sorafenib group. The median progression-free survival was 6.9 and 4.3, respectively. The presented clinical observation describes a case of treatment of a patient with unresectable HCC, a large tumor burden and portal vein thrombosis. In the first line of therapy, we considered the combination of atezolizumab and bevacizumab. A rapid response to the therapy was obtained, a complete response was registered after 42 months of therapy with a combination of atezolizumab and bevacizumab. A minimum number of adverse events and satisfactory tolerability were noted. Currently, the patient continues therapy with this combination. Currently, an increasing number of patients receive therapy with atezolizumab and bevacizumab for a long time. Experience is accumulating in real clinical practice of monitoring patients who have been receiving a combination of immunooncologic and targeted drugs for a long time.