Key clinical point: Cabozantinib plus atezolizumab significantly improved progression-free survival (PFS) but not overall survival (OS) in systemic therapy-naive patients with advanced hepatocellular carcinoma (HCC) unresponsive to curative or locoregional therapy.
Major finding: Patients receiving cabozantinib plus atezolizumab vs sorafenib had a significantly longer median PFS (6.8 vs 4.2 months; hazard ratio [HR] 0.63; P = .001) but a comparable median OS (15.4 vs 15.5 months; HR 0.90; P = .44).
Study details: Findings are from a multicenter, phase 3 trial, COSMIC-312, that included 837 systemic therapy-naive adult patients with HCC unresponsive to curative or locoregional therapy who were randomly assigned 2:1:1 to receive cabozantinib plus atezolizumab (n = 432), sorafenib (n = 217), or single-agent cabozantinib (n = 188).
Disclosures: This study was funded by Exelixis, USA, and Ipsen, France. Some authors reported being consultants, advisors, or speakers for or receiving research funding, personal fees, travel and accommodations, or other expenses from various sources, including Exelixis and Ipsen. Four authors reported employment (current or former), stock, and other ownership interests in Exelixis or Ipsen.
Source: Kelley RK et al. Cabozantinib plus atezolizumab versus sorafenib for advanced hepatocellular carcinoma (COSMIC-312): A multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2022 (Jul 4). Doi: 10.1016/S1470-2045(22)00326-6