Objective: To evaluate outcomes of subsequent active treatment after atezolizumab–bevacizumab (AB) in patients with hepatocellular carcinoma (HCC).
Methods: This descriptive study combined retrospective and prospective data from K Hospital between 2019 and 2026. Of 238 patients treated with AB, 84 (35.3%) received subsequent active treatment and were included. Tumor response was assessed using mRECIST; PFS2 and OS2 were measured from initiation of subsequent treatment. There was no supportive-care-only control group.
Results: ORR and DCR were 10.7% and 69.0% in the overall cohort and 12.3% and 79.5% among radiologically evaluable patients. Median PFS2 and OS2 were 5.2 and 12.1 months. Progression or discontinuation of AB within ≤3 months was independently associated with poorer OS2 (HR 1.97; 95% CI, 1.04–3.73; p = 0.037). Sorafenib and lenvatinib were used in 54.8% and 35.7% of patients, respectively. No statistically significant difference in PFS2 or OS2 was observed between sorafenib and lenvatinib.
Conclusion: Among selected patients who remained eligible for active treatment after AB, TKIs were the most common subsequent therapies, with the observed survival outcomes reported above. AB treatment duration ≤3 months was associated with poorer OS2 and warrants validation in an independent cohort.