From the Guidelines
Atezolizumab plus bevacizumab for hepatocellular carcinoma (HCC) should be administered as an intravenous infusion every 3 weeks, with atezolizumab 1200 mg and bevacizumab 15 mg/kg, until disease progression or unacceptable toxicity occurs, as recommended by the most recent guidelines 1. The administration duration of this combination is not predetermined and is based on the clinical judgment of disease progression or unacceptable toxicity. Key considerations for the administration of atezolizumab and bevacizumab include:
- Pre-treatment endoscopic evaluation and management of esophageal varices due to the increased risk of gastrointestinal bleeding associated with bevacizumab 1
- Baseline and regular monitoring of liver function, blood pressure, and proteinuria throughout treatment
- The combination's mechanism of action, which includes atezolizumab's immune checkpoint inhibition and bevacizumab's anti-angiogenic effects, providing a complementary approach to treating HCC 1 This regimen has been established as a first-line standard of care for advanced HCC, offering improved survival outcomes compared to previous standards, as outlined in the 2022 clinical practice guideline on systemic therapy for hepatocellular carcinoma 1.
From the FDA Drug Label
Administer TECENTRIQ as 840 mg every 2 weeks, 1200 mg every 3 weeks, or 1680 mg every 4 weeks. Administer TECENTRIQ prior to bevacizumab when given on the same day. Bevacizumab is administered at 15 mg/kg every 3 weeks.
The administration duration of the atezolizumab (Tecentriq) and bevacizumab (Avastin) combination for Hepatocellular Carcinoma (HCC) is not explicitly stated in terms of overall treatment duration. However, the dosing frequency is provided as:
- Atezolizumab: 840 mg every 2 weeks, 1200 mg every 3 weeks, or 1680 mg every 4 weeks
- Bevacizumab: 15 mg/kg every 3 weeks 2
From the Research
Administration Duration of Atezolizumab and Bevacizumab Combination
- The administration duration of the atezolizumab and bevacizumab combination for Hepatocellular Carcinoma (HCC) is every 3 weeks 3, 4.
- In the GO30140 phase 1b study, patients received atezolizumab (1200 mg) and bevacizumab (15 mg/kg) intravenously every 3 weeks 3.
- The phase II study of atezolizumab and bevacizumab combination therapy for patients with advanced HCC previously treated with lenvatinib also administered the combination every 3 weeks 4.
- There is no specific information on the maximum administration duration, but the studies suggest that the combination is administered until disease progression or unacceptable toxicity 3, 4.
Dosing Schedule
- The dosing schedule for atezolizumab is 1200 mg intravenously every 3 weeks 3, 4.
- The dosing schedule for bevacizumab is 15 mg/kg intravenously every 3 weeks 3, 4.
Clinical Trials and Studies
- The GO30140 phase 1b study and the phase II study of atezolizumab and bevacizumab combination therapy provide evidence for the administration duration and dosing schedule of the combination 3, 4.
- Other studies, such as the IMbrave150 phase 3 trial and the DEMAND trial, also investigate the use of atezolizumab and bevacizumab in HCC, but do not provide specific information on the administration duration 5, 6, 7.