Liver resection after atezolizumab and bevacizumab versus maintenance therapy for locally advanced hepatocellular carcinoma (TALENTOP): a multicentre, open-label, randomised, phase 3 trial

In the randomised phase 3 TALENTOP trial (24 hospitals in China), patients with hepatocellular carcinoma and macrovascular invasion first received atezolizumab plus bevacizumab; 201 were then randomly assigned to liver resection (n=101) or continued systemic therapy (n=100). Median time to treatment failure was 20.4 months after surgery versus 11.8 months with maintenance therapy (HR 0.60; 95% CI 0.39-0.91; p=0.015). The benefit carries an explicit cost: grade 3-4 treatment-related adverse events occurred in 39% of surgical patients versus 21% on maintenance, and two treatment-related deaths occurred in the surgery group. The primary endpoint was time to treatment failure — the report does not provide overall survival results.