Concurrent transarterial chemoembolization plus atezolizumab and bevacizumab in unresectable hepatocellular carcinoma: Interim analysis from a multicenter real-world study (CHANCE 023).

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Background: Combining transarterial chemoembolization (TACE) with systemic therapies such as atezolizumab and bevacizumab (T+A) has shown potential efficacy in patients with unresectable Hepatocellular carcinoma (HCC) This interim analysis aims to evaluate the efficacy and safety of this combination therapy when administered concurrently within a two-month period. Methods: This multicenter, real-world study included patients diagnosed with unresectable HCC who received TACE combined with T+A from January 2020 to June 2024, across 37 centers in mainland China. The primary endpoint was overall survival (OS). This trial is registered with ClinicalTrials.gov, NCT06024252. Results: Out of a cohort of 335 patients, 293 (259 males) met the inclusion criteria, and 37.5% (112/293) adopted this regimen as second-line therapy. The interim analysis showed a median OS of 29.97 months and a one-year survival rate of 76.50%. The median PFS was 19.23 months, and the objective response rate (ORR) was 41.6%, with 26 complete responses and 96 partial responses. The disease control rate (DCR) was 84.6%. Common adverse events included bone marrow suppression, decreased white blood cell or platelet counts, among others. Serious adverse events occurred in 9.2% of patients (27/293) and were manageable with standard interventions. Conclusions: This study is a real-world analysis to highlight the potential benefits of combining TACE with T+A in this patient population. However, longer follow-up is required to better assess both overall survival and the long-term safety profile of this treatment strategy. Clinical trial information: NCT06024252 .