A myeloid immunosuppressive phenotype defines primary refractoriness to atezolizumab plus bevacizumab in hepatocellular carcinoma.

Primary refractoriness to atezolizumab plus bevacizumab in hepatocellular carcinoma is linked to inferior overall survival (7.3 vs 31.5 months) and a myeloid immunosuppressive tumour microenvironment.

• Why it matters: Early progression or short-lived stabilisation after frontline A+B remains poorly explained, limiting biomarker-stratified trial design for unresectable hepatocellular carcinoma.
• What they did: In 1,296 AB-real patients and 645 trial participants, SITC-defined PRef was assessed using machine learning tumour-infiltrating lymphocyte quantification, imaging mass cytometry, and RNA-seq, with refinement by single-cell RNA-seq (n = 20) and imaging mass cytometry (n = 16).
• The result: PRef was associated with NLR ≥3, CD163+ tumour-associated macrophages and vascular cancer-associated fibroblasts, higher Treg/Teff ratio, and IFN-γ signature downregulation; about 40% of patients met SITC criteria.

AI summary of the abstract · may contain errors · not medical advice · read the paper.