Multicenter phase 3 trial of first-line toripalimab plus bevacizumab versus sorafenib for advanced hepatocellular carcinoma

The phase 3 HEPATORCH trial, at 57 centers in China, compared the combination of toripalimab plus bevacizumab versus sorafenib as first-line treatment for advanced hepatocellular carcinoma (aHCC). Median progression-free survival was 5.8 months with toripalimab-bevacizumab versus 4.0 months with sorafenib (HR 0.69; p=0.0086) and median overall survival was 20.0 months versus 14.5 months (HR 0.76; p=0.039). Grade 3 or higher adverse events occurred in 63% versus 61% and led to discontinuation in 13% versus 12%. Grade 5 treatment-related adverse events occurred in two patients (1%) versus one patient (1%). The authors conclude that among patients with previously untreated aHCC, toripalimab plus bevacizumab improved PFS and OS versus sorafenib, with an acceptable safety profile.