Evidence map›Paper›PMID 41545308›Full record

ArticleJournal for immunotherapy of cancer2026

Primary and secondary pseudo-stability and progression after atezolizumab with and without bevacizumab.

Saiabhiroop Govindu, Prashanth Gowda, Maishara Muquith, Magdalena Espinoza, David Hsiehchen

Abstract read
In one paragraph

Article in Journal for immunotherapy of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Saiabhiroop GovinduDivison of Hematology and Oncology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Prashanth GowdaDivison of Hematology and Oncology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Maishara MuquithDivison of Hematology and Oncology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Magdalena EspinozaDivision of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
David HsiehchenHarold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, Texas, USA david.hsieh@utsouthwestern.edu.ORCID http://orcid.org/0000-0001-9139-302X

Funding

UT Southwestern Liver Cancer SPOREP50CA295495 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI ELISABETH D MARTINEZ · 2025 to 2026
$7.5M
Defining mechanisms of immunotherapy resistance and targeting TIGIT in hepatobiliary cancersK08CA290062 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI David Hsieh · 2025 to 2026
$542k
NCI NIH HHS K08 CA290062NCI NIH HHS P50 CA295495
6 · The paper itself

Abstract

backgroundAtypical tumor response patterns associated with immunotherapies pose significant challenges for assessing treatment response and clinical decision-making. We characterized the epidemiology, clinical impact, and molecular determinants of pseudo-stability/progression after atezolizumab with and without bevacizumab across several histologies.

methodsPost hoc individual-level analysis of 2980 patients across eight randomized trials of atezolizumab in non-small cell lung cancer, urothelial carcinoma, renal cell carcinoma (RCC), and hepatocellular carcinoma.

resultsAnalyses of the temporal characteristics of atypical responses revealed two distinct patterns including primary and secondary pseudo-stability/progression. Primary pseudo-stability/progression is characterized by initial disease progression and subsequent regression, which occurs in 7.7%-12.5% of patients according to cancer type. In contrast, secondary progression is characterized by initial disease control with subsequent radiographic progression followed by tumor regression, and this occurs in 4.4%-10.8% of patients according to cancer type. Compared with patients matched by the same initial radiographic response, primary and secondary pseudo-stability/progression could be associated with similar or inferior overall survival outcomes depending on the cancer type and classification of the initial tumor response. Exploratory analyses indicate that clinical factors are not predictive of atypical responses, but pseudo-stability/progression could be associated with distinct genomic alterations including

conclusionsPrimary and secondary pseudo-stability/progression occur in a non-trivial proportion of patients across cancer types. Outcomes after pseudo-stability/progression are dependent on cancer type and initial response. Uncovering the clinical and molecular features of pseudo-stability/progression subtypes may guide treatment decisions and identify patients who may benefit from continued immunotherapy despite radiographic progression.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsBevacizumabDisease ProgressionFemaleHumansMaleAntibodies, Monoclonal, HumanizedatezolizumabBevacizumabBladder CancerHepatocellular CarcinomaImmune Checkpoint InhibitorKidney CancerLung Cancer

Identifiers

PMID41545308
PMCPMC12815109

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.