Efficacy and Treatment Strategies in Advanced Cancers with Liver Metastasis Receiving Atezolizumab Therapy

Figures & data

Figure 1 The efficacy of atezolizumab versus standard therapy in terms of liver metastasis (LM). Forest plots of hazard ratios (HRs) with 95% confidence intervals (CIs) for (A) progression-free survival (PFS) and (B) overall survival (OS) in pan-cancer across treatment lines, comparing atezolizumab and standard therapy in patients with and without LM respectively. Kaplan-Meier estimates of OS with atezolizumab versus docetaxel in (C) LM population and (D) non-LM population in an individual non-small cell lung cancer cohort.

Table 1 Biomarker Screening by Calculating Hazard Ratio of Atezolizumab versus Docetaxel with 95% Confidence Interval (CI) and Corresponding P-value for Each Clinical Characteristic in the Liver Metastatic Population from the OAK Cohort

Clinical Characteristic	Number (Doce)	Number (Atezo)	Hazard Ratio (Atezo vs Doce)	95% CI	P-value
PD-L1
TC3 or IC3	13	15	0.395	0.167–0.937	0.015
TC0/1/2 and IC0/1/2	80	68	0.986	0.689–1.411	0.939
bTMB Status
bTMB-High	19	18	0.660	0.327–1.329	0.216
bTMB-Low	57	47	0.762	0.498–1.166	0.207
SLD
<2	16	9	0.917	0.378–2.228	0.840
≥2	78	74	0.776	0.546–1.103	0.155
Metastatic Sites
<4	52	38	0.929	0.584–1.477	0.754
≥4	42	45	0.707	0.442–1.131	0.140
ECOG PS
0	29	26	0.700	0.379–1.293	0.252
1	65	57	0.898	0.610–1.323	0.584
Race
Asian	20	16	0.730	0.352–1.517	0.394
White	68	62	0.823	0.565–1.201	0.311
Other	6	5	1.416	0.322–6.236	0.642
Gender
Male	52	55	0.842	0.553–1.283	0.415
Female	42	28	0.792	0.469–1.335	0.383
Histology
Squamous	20	24	0.561	0.292–1.078	0.068
Non-Squamous	74	59	0.930	0.635–1.364	0.710
Prior Chemotherapy
1	72	66	0.772	0.532–1.123	0.174
2	22	17	1.000	0.508–1.968	1.000
Smoking Status
Never	22	18	0.977	0.483–1.976	0.948
Previous/Current	72	65	0.760	0.525–1.102	0.141

Abbreviations: SLD, sum of the longest diameters; Doce, docetaxel; Atezo, atezolizumab; bTMB, tumor mutation burden in blood; ECOG PS, eastern cooperative oncology group performance status.

Figure 2 Impact of PD-L1 strong expression on efficacy of atezolizumab versus chemotherapy regarding liver metastasis (LM). Kaplan-Meier estimates of overall survival (OS) comparing atezolizumab and docetaxel in (A) all LM patients, (B) LM patients with a PD-L1 expression level of TC3 or IC3, (C) LM patients with a PD-L1 expression level of TC 0/1/2 or IC0/1/2, (D) all non-LM patients, (E) non-LM patients with TC3 or IC3, and (F) non-LM patients with TC0/1/2 or IC0/1/2.

Figure 3 Combination of PD-L1 expression and liver metastasis (LM) for risk stratification of patients received atezolizumab. Kaplan-Meier estimates of overall survival (OS) stratified by LM status in (A) the OAK cohort and (B) the IMvigor210 cohort. Kaplan-Meier estimates of OS stratified by LM status and PD-L1 expression level in (C) the OAK cohort and (D) the IMvigor210 cohort.

Figure 4 Association of PD-L1 strong expression and liver metastasis (LM) with immune profiles. Immune phenotype distributions by (A) liver metastatic status and (B) combination of liver metastatic status and PD-L1 strong expression status. (C) T-effector gene expression as a function of PD-L1 strong expression and liver metastatic status.