Racial disparities in advanced hepatocellular carcinoma (aHCC) patients treated with atezolizumab plus bevacizumab (A+B): A real-world evidence study.

Abstract

514 Background: A+B is established as the standard first-line therapy for patients with aHCC. However, there is a paucity of evidence regarding potential racial differences in treatment outcomes with A+B. We conducted a retrospective comparative analysis using real-world evidence (RWE), in accordance with the ESMO Guidance for Reporting Oncology Real-World Evidence (ESMO-GROW) criteria. Methods: Data were obtained from the TriNetX Global Collaborative Network, which aggregates retrospective anonymized clinical records from healthcare organizations worldwide. Patients with aHCC meeting prespecified eligibility criteria were identified across 150 institutions. Overall survival (OS) was compared between White (W), Black (B), and Asian (A) cohorts using Kaplan–Meier analysis. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to assess survival differences. Propensity score matching (PSM) was applied to adjust for potential confounders, including age and sex. All statistical analyses were performed within the TriNetX Analytics platform. Results: A total of 1173 patients with aHCC were identified, of whom 907 fulfilled the inclusion criteria: 671 W, 128 B, and 108 A. In the unadjusted comparison, B patients had longer median OS compared with W patients (27.1 vs. 15.1 months; HR 1.57, 95% CI 1.13–2.04, p = 0.0056). No significant differences in OS were observed between W vs. A or B vs. A cohorts. After PSM, the W vs. B comparison no longer showed significant OS differences (HR 1.03, 95% CI 0.72–1.48). Conclusions: In this RWE study, racial background did not significantly influence the efficacy of atezolizumab plus bevacizumab in patients with advanced hepatocellular carcinoma.