Abstract: International audience ; The efficacy of atezolizumab/bevacizumab has never been reported in patients with metastatic/unresectable combined hepatocellular‐cholangiocarcinoma (cHCC‐CCA). Patients and Methods We retrospectively included patients with a histological diagnosis of unresectable/metastatic cHCC‐CCA and treated with atezolizumab/bevacizumab (2020–2022) in 7 centers. Clinical and radiological features were collected at the beginning of atezolizumab/bevacizumab. We reported the radiological response using RECIST criteria, overall survival (OS) and progression‐free survival (PFS). Results Sixteen patients with cHCC‐CCA were included and were predominantly male (75%) with advanced fibrosis/cirrhosis (69%). Nine patients received atezolizumab/bevacizumab as a first‐line systemic treatment, 5 as a second line, 1 as a third line and 1 as a fifth line. Severe digestive bleeding occurred in 2 patients. Among the 9 patients treated in the first line, 4 experienced radiological progression, 3 partial response and 1 had stable disease. Patients treated with atezolizumab/bevacizumab in the first line had a median OS of 13 months and a median PFS of 3 months. Among the 7 patients receiving atezolizumab/bevacizumab as a second line or more, 4 patients harbored a stable disease, 2 a partial response, and 1 a progressive disease. Conclusions The combination of atezolizumab and bevacizumab showed signs of anti‐tumor efficacy in patients with unresectable/metastatic cHCC‐CCA.
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