{"entity":{"id":"imbrave150","kind":"trial","name":"IMbrave150","aka":[],"tldr":"The trial that ended the sorafenib era: immunotherapy plus an anti-VEGF antibody became the new first-line standard for liver cancer.","summary":"IMbrave150, trial NCT03434379 sponsored by Roche and reported in 2020, ended the sorafenib era by making atezolizumab plus bevacizumab the new first-line standard for unresectable hepatocellular carcinoma. It randomised 501 patients and met both primary endpoints of overall and progression-free survival, with a much higher response rate, becoming the first regimen to beat sorafenib on survival, though bevacizumab's bleeding risk means patients need endoscopy for varices first. OnCo links it to PD-L1 and VEGF as targets, atezolizumab, Richard S. Finn, Ann-Lii Cheng and Ho Yeong Lim, and to the caution pairing about bevacizumab with untreated varices; the result is consistent with the class effect seen in CARES-310 and ORIENT-32. Whether it remains the preferred first-line regimen against dual checkpoint blockade from HIMALAYA and CheckMate 9DW is the open question.","status":"positive","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT03434379","url":"https://clinicaltrials.gov/study/NCT03434379"},{"label":"IMbrave150 response characterisation","url":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8366100/"}],"tags":[],"related":[],"cancers":["hcc","hcc-advanced"],"sections":[],"technologies":["checkpoint-inhibitor"],"targets":["pdl1","vegf"],"drugs":["atezolizumab"],"companies":["roche-genentech"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["richard-finn","ann-lii-cheng","lim-ho-yeong"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT03434379","phase":"3","setting":"First-line unresectable HCC: atezolizumab + bevacizumab vs sorafenib","sponsor":"Roche","result":"OS 19.2 vs 13.4 months, HR 0.66.","started":"2018-03-15","startedType":"actual","yearReported":2020,"enrolled":501,"enrolledBasis":"registry","outcomes":[{"endpoint":"Overall survival (updated)","primary":true,"unit":"months","arms":[{"name":"Atezolizumab + bevacizumab","n":336,"value":19.2},{"name":"Sorafenib","n":165,"value":13.4}],"hr":0.66,"ci":[0.52,0.85],"source":"https://doi.org/10.1056/NEJMoa1915745"},{"endpoint":"Progression-free survival","primary":true,"unit":"months","arms":[{"name":"Atezolizumab + bevacizumab","value":6.9},{"name":"Sorafenib","value":4.3}],"hr":0.65,"source":"https://doi.org/10.1056/NEJMoa1915745"},{"endpoint":"Objective response rate","unit":"%","arms":[{"name":"Atezolizumab + bevacizumab","value":30},{"name":"Sorafenib","value":11}],"source":"https://doi.org/10.1056/NEJMoa1915745"}],"replication":"Consistent with real-world cohorts and with the anti-VEGF + PD-(L)1 class effect seen in CARES-310 and ORIENT-32."},"route":"/trials/imbrave150/","neighbours":{"cancer":[{"id":"hcc-advanced","kind":"cancer","name":"Advanced hepatocellular carcinoma (BCLC C)","route":"/cancers/hcc-advanced/"},{"id":"hcc","kind":"cancer","name":"Hepatocellular carcinoma","route":"/cancers/hcc/"},{"id":"hcc-intermediate","kind":"cancer","name":"Intermediate hepatocellular carcinoma (BCLC B)","route":"/cancers/hcc-intermediate/"}],"technology":[{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"}],"target":[{"id":"pdl1","kind":"target","name":"PD-L1","route":"/targets/pdl1/"},{"id":"vegf","kind":"target","name":"VEGF / VEGFR","route":"/targets/vegf/"}],"drug":[{"id":"atezolizumab","kind":"drug","name":"Atezolizumab","route":"/drugs/atezolizumab/"}],"company":[{"id":"roche-genentech","kind":"company","name":"Roche / Genentech","route":"/companies/roche-genentech/"}],"person":[{"id":"ann-lii-cheng","kind":"person","name":"Ann-Lii Cheng","route":"/people/ann-lii-cheng/"},{"id":"lim-ho-yeong","kind":"person","name":"Ho Yeong Lim","route":"/people/lim-ho-yeong/"},{"id":"richard-finn","kind":"person","name":"Richard S. Finn","route":"/people/richard-finn/"}],"pairing":[{"id":"io-varices-caution","kind":"pairing","name":"Caution: bevacizumab-based regimens with untreated varices","route":"/pairings/io-varices-caution/"}],"idea":[{"id":"idea-hcc-io-before-transplant","kind":"idea","name":"Immunotherapy downstaging to transplant with a safe washout","route":"/ideas/idea-hcc-io-before-transplant/"}],"paper":[{"id":"paper-atezolizumab-hcc-j-hepatol-2022","kind":"paper","name":"Updated efficacy and safety data from IMbrave150: Atezolizumab plus bevacizumab vs. sorafenib for unresectable hepatocellular carcinoma","route":"/key-papers/paper-atezolizumab-hcc-j-hepatol-2022/"}]}}