New predictive score of outcomes with first-line atezolizumab plus bevacizumab for unresectable hepatocellular carcinoma

Atezolizumab plus bevacizumab (AB) and lenvatinib both are approved first-line treatments for unresectable hepatocellular carcinoma (uHCC). A multinational retrospective study found that among AB-treated patients, outcomes were better among patients with baseline low α-fetoprotein, low alkaline phosphatase, and high eosinophil count. Based on these three variables, the α-FAtE score was generated. AB-treated patients with a high α-FAtE score had better OS and TTP compared with AB-treated patients with a low α-FAtE score. This association was not seen among lenvatinib-treated patients. AB was superior to lenvatinib among patients with high α-FAtE score (HR 0.55; p=0.0043) but inferior among patients with a low α-FAtE score (HR 1.75; p=0.0227). The authors conclude that, if validated in prospective studies, the α-FAtE score could guide therapeutic choice between first-line AB and lenvatinib for uHCC.