1. Genomic biomarkers to predict response to atezolizumab plus bevacizumab immunotherapy in hepatocellular carcinoma: Insights from the IMbrave150 trial.
- Author
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Yim SY, Lee SH, Baek SW, Sohn B, Jeong YS, Kang SH, Park K, Park H, Lee SS, Kaseb AO, Park YN, Leem SH, Curran MA, Kim JH, and Lee JS
- Subjects
- Humans, Male, Sorafenib therapeutic use, Female, Immunotherapy, Middle Aged, Aged, Nivolumab therapeutic use, Carcinoma, Hepatocellular drug therapy, Carcinoma, Hepatocellular therapy, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular genetics, Bevacizumab therapeutic use, Liver Neoplasms drug therapy, Liver Neoplasms therapy, Liver Neoplasms pathology, Antibodies, Monoclonal, Humanized therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Biomarkers, Tumor genetics, Biomarkers, Tumor metabolism
- Abstract
Background/aims: Combination immunotherapy, exemplified by atezolizumab plus bevacizumab, has become the standard of care for inoperable hepatocellular carcinoma (HCC). However, the lack of predictive biomarkers and limited understanding of response mechanisms remain a challenge., Methods: Using data from the IMbrave150plus cohort, we applied an immune signature score (ISS) predictor to stratify HCC patients treated with atezolizumab plus bevacizumab or with sorafenib alone into potential high and low response groups. By applying multiple statistical approaches including a Bayesian covariate prediction algorithm, we refined the signature to 10 key genes (ISS10) for clinical use while maintaining similar predictive power to the full model. We further validated ISS10 in an independent HCC cohort treated with nivolumab plus ipilimumab., Results: The study identified a significant association between the ISS and treatment response. Among patients classified as high responders, those treated with the atezolizumab plus bevacizumab combination exhibited improved overall and progression-free survival as well as better objective response rate compared to those treated with sorafenib. We also observed a significant correlation between ISS10 and response to nivolumab plus ipilimumab treatment. Analysis of immune cell subpopulations revealed distinct characteristics associated with ISS subtypes. In particular, the ISS10 high subtype displayed a more favorable immune environment with higher proportions of antitumor macrophages and activated T-cells, potentially explaining its better response., Conclusion: Our study suggests that ISS and ISS10 are promising predictive biomarkers for enhanced therapeutic outcomes in HCC patients undergoing combination immunotherapy. These markers are crucial for refining patient stratification and personalized treatment approaches to advance the effectiveness of standard-of-care regimens.
- Published
- 2024
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