Nivolumab as Second-Line Therapy Improves Survival in Patients with Unresectable Hepatocellular Carcinoma
Limited data exists for the efficacy and outcomes of nivolumab as a second-line treatment for unresectable hepatocellular carcinoma (uHCC). We aimed to assess the efficacy and safety of nivolumab in patients with uHCC who experienced disease progression during sorafenib treatment. In this retrospect...
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description | Limited data exists for the efficacy and outcomes of nivolumab as a second-line treatment for unresectable hepatocellular carcinoma (uHCC). We aimed to assess the efficacy and safety of nivolumab in patients with uHCC who experienced disease progression during sorafenib treatment.
In this retrospective, observational, multicenter study, adult Child-Turcotte-Pugh A/7B patients with uHCC who tolerated sorafenib therapy but showed disease progression switched to second-line intravenous nivolumab (
= 42). A similar number of consecutive, unselected patients who were maintained on sorafenib therapy, regardless of tumoral response or progression, served as historical controls (
= 38). The primary endpoint was overall survival (OS, defined as the time from starting sorafenib in either group up to death due to any cause) and analyzed by intention-to-treat.
The mean age of the overall cohort was 72.4 ± 10.1 years, of whom 87.5% were males and 58.8% had underlying viral etiology. Patients in the two cohorts were similar, except those who received nivolumab had more co-morbidities (70.0% vs. 15.4%), ECOG-2 status (21.4% vs. 15.8%), BCLC stage C (81.0% vs. 47.4%), and extravascular invasion (54.4% vs. 21.8%) (
< 0.05 for all). More patients in the nivolumab arm were Child-Turcotte-Pugh B (35.7% vs. 21.1%,
= 0.15). Median OS was 22.2 months (95% CI: 8.9-49.8) on second-line nivolumab and 11.0 months (95% CI: 3.6-18.4) on sorafenib alone (HR 1.93; 95% CI: 1.1-3.3,
= 0.014). Median OS after starting nivolumab was 10.2 months, and time-to-progression was 4.9 months (95% CI: 3.2-6.3).
Nivolumab is an effective second-line treatment option in patients with uHCC who progress on sorafenib, with significantly improved OS. These early real-life data offer encouraging results, similar to those shown in Phase I/IIa clinical trials. Further investigations are warranted for the use of nivolumab as a monotherapy. |
doi_str_mv | 10.3390/cancers16122196 |
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In this retrospective, observational, multicenter study, adult Child-Turcotte-Pugh A/7B patients with uHCC who tolerated sorafenib therapy but showed disease progression switched to second-line intravenous nivolumab (
= 42). A similar number of consecutive, unselected patients who were maintained on sorafenib therapy, regardless of tumoral response or progression, served as historical controls (
= 38). The primary endpoint was overall survival (OS, defined as the time from starting sorafenib in either group up to death due to any cause) and analyzed by intention-to-treat.
The mean age of the overall cohort was 72.4 ± 10.1 years, of whom 87.5% were males and 58.8% had underlying viral etiology. Patients in the two cohorts were similar, except those who received nivolumab had more co-morbidities (70.0% vs. 15.4%), ECOG-2 status (21.4% vs. 15.8%), BCLC stage C (81.0% vs. 47.4%), and extravascular invasion (54.4% vs. 21.8%) (
< 0.05 for all). More patients in the nivolumab arm were Child-Turcotte-Pugh B (35.7% vs. 21.1%,
= 0.15). Median OS was 22.2 months (95% CI: 8.9-49.8) on second-line nivolumab and 11.0 months (95% CI: 3.6-18.4) on sorafenib alone (HR 1.93; 95% CI: 1.1-3.3,
= 0.014). Median OS after starting nivolumab was 10.2 months, and time-to-progression was 4.9 months (95% CI: 3.2-6.3).
Nivolumab is an effective second-line treatment option in patients with uHCC who progress on sorafenib, with significantly improved OS. These early real-life data offer encouraging results, similar to those shown in Phase I/IIa clinical trials. Further investigations are warranted for the use of nivolumab as a monotherapy.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers16122196</identifier><identifier>PMID: 38927902</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Ascites ; Cancer ; Cancer patients ; Cancer therapies ; Care and treatment ; Clinical trials ; Comparative analysis ; Hepatocellular carcinoma ; Kinases ; Liver ; Liver cancer ; Liver diseases ; Oncology, Experimental ; Patient outcomes ; Patients ; Survival ; Toxicity ; Tumors</subject><ispartof>Cancers, 2024-06, Vol.16 (12), p.2196</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 by the authors. 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0002-3830-9236 ; 0000-0003-2017-3526</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11202187/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11202187/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38927902$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sanai, Faisal M</creatorcontrib><creatorcontrib>Odah, Hassan O</creatorcontrib><creatorcontrib>Alshammari, Kanan</creatorcontrib><creatorcontrib>Alzanbagi, Adnan</creatorcontrib><creatorcontrib>Alsubhi, Murooj</creatorcontrib><creatorcontrib>Tamim, Hani</creatorcontrib><creatorcontrib>Alolayan, Ashwaq</creatorcontrib><creatorcontrib>Alshehri, Ahmed</creatorcontrib><creatorcontrib>Alqahtani, Saleh A</creatorcontrib><title>Nivolumab as Second-Line Therapy Improves Survival in Patients with Unresectable Hepatocellular Carcinoma</title><title>Cancers</title><addtitle>Cancers (Basel)</addtitle><description>Limited data exists for the efficacy and outcomes of nivolumab as a second-line treatment for unresectable hepatocellular carcinoma (uHCC). We aimed to assess the efficacy and safety of nivolumab in patients with uHCC who experienced disease progression during sorafenib treatment.
In this retrospective, observational, multicenter study, adult Child-Turcotte-Pugh A/7B patients with uHCC who tolerated sorafenib therapy but showed disease progression switched to second-line intravenous nivolumab (
= 42). A similar number of consecutive, unselected patients who were maintained on sorafenib therapy, regardless of tumoral response or progression, served as historical controls (
= 38). The primary endpoint was overall survival (OS, defined as the time from starting sorafenib in either group up to death due to any cause) and analyzed by intention-to-treat.
The mean age of the overall cohort was 72.4 ± 10.1 years, of whom 87.5% were males and 58.8% had underlying viral etiology. Patients in the two cohorts were similar, except those who received nivolumab had more co-morbidities (70.0% vs. 15.4%), ECOG-2 status (21.4% vs. 15.8%), BCLC stage C (81.0% vs. 47.4%), and extravascular invasion (54.4% vs. 21.8%) (
< 0.05 for all). More patients in the nivolumab arm were Child-Turcotte-Pugh B (35.7% vs. 21.1%,
= 0.15). Median OS was 22.2 months (95% CI: 8.9-49.8) on second-line nivolumab and 11.0 months (95% CI: 3.6-18.4) on sorafenib alone (HR 1.93; 95% CI: 1.1-3.3,
= 0.014). Median OS after starting nivolumab was 10.2 months, and time-to-progression was 4.9 months (95% CI: 3.2-6.3).
Nivolumab is an effective second-line treatment option in patients with uHCC who progress on sorafenib, with significantly improved OS. These early real-life data offer encouraging results, similar to those shown in Phase I/IIa clinical trials. Further investigations are warranted for the use of nivolumab as a monotherapy.</description><subject>Ascites</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Clinical trials</subject><subject>Comparative analysis</subject><subject>Hepatocellular carcinoma</subject><subject>Kinases</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Liver diseases</subject><subject>Oncology, Experimental</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Survival</subject><subject>Toxicity</subject><subject>Tumors</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkU1v1DAQhiNERau2Z27IEhcuKf7aOD6hagVtpRUg0Z6jiTPZdeXYwU6C-u_xlhZaVPtga-bxO_N6iuIto2dCaPrRgDcYE6sY50xXr4ojThUvq0rL10_uh8VpSrc0LyGYqtSb4lDUmitN-VFhv9oluHmAlkAiP9AE35Ub65Fc7zDCeEeuhjGGBXNyjotdwBHryXeYLPopkV922pEbHzGhmaB1SC5xhCkYdG52EMkaorE-DHBSHPTgEp4-nMfFzZfP1-vLcvPt4mp9vim3Qoip5LUSknZUVbVCTjvZg5Y9rwyvQTNZG9a3TPEVywHa874F2aFsqdBqpYArcVx8-qM7zu2AncltRnDNGO0A8a4JYJvnGW93zTYsDWOcclbvFT48KMTwc8Y0NYNNe0PgMcypEflnayqkrDL6_j_0NszRZ3_3FFc1o_oftQWHjfV9yIXNXrQ5V1rLlWRsT529QOXd4WDzXLC3Of7swbunTv9afJyu-A1R6KfR</recordid><startdate>20240611</startdate><enddate>20240611</enddate><creator>Sanai, Faisal M</creator><creator>Odah, Hassan O</creator><creator>Alshammari, Kanan</creator><creator>Alzanbagi, Adnan</creator><creator>Alsubhi, Murooj</creator><creator>Tamim, Hani</creator><creator>Alolayan, Ashwaq</creator><creator>Alshehri, Ahmed</creator><creator>Alqahtani, Saleh A</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3830-9236</orcidid><orcidid>https://orcid.org/0000-0003-2017-3526</orcidid></search><sort><creationdate>20240611</creationdate><title>Nivolumab as Second-Line Therapy Improves Survival in Patients with Unresectable Hepatocellular Carcinoma</title><author>Sanai, Faisal M ; Odah, Hassan O ; Alshammari, Kanan ; Alzanbagi, Adnan ; Alsubhi, Murooj ; Tamim, Hani ; Alolayan, Ashwaq ; Alshehri, Ahmed ; Alqahtani, Saleh A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g333t-287340d07687e20d4fa94f26c28a9148c1fb17251c280f2fba4de4b039757a273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Ascites</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Clinical trials</topic><topic>Comparative analysis</topic><topic>Hepatocellular carcinoma</topic><topic>Kinases</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Liver diseases</topic><topic>Oncology, Experimental</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Survival</topic><topic>Toxicity</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sanai, Faisal M</creatorcontrib><creatorcontrib>Odah, Hassan O</creatorcontrib><creatorcontrib>Alshammari, Kanan</creatorcontrib><creatorcontrib>Alzanbagi, Adnan</creatorcontrib><creatorcontrib>Alsubhi, Murooj</creatorcontrib><creatorcontrib>Tamim, Hani</creatorcontrib><creatorcontrib>Alolayan, Ashwaq</creatorcontrib><creatorcontrib>Alshehri, Ahmed</creatorcontrib><creatorcontrib>Alqahtani, Saleh A</creatorcontrib><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancers</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sanai, Faisal M</au><au>Odah, Hassan O</au><au>Alshammari, Kanan</au><au>Alzanbagi, Adnan</au><au>Alsubhi, Murooj</au><au>Tamim, Hani</au><au>Alolayan, Ashwaq</au><au>Alshehri, Ahmed</au><au>Alqahtani, Saleh A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nivolumab as Second-Line Therapy Improves Survival in Patients with Unresectable Hepatocellular Carcinoma</atitle><jtitle>Cancers</jtitle><addtitle>Cancers (Basel)</addtitle><date>2024-06-11</date><risdate>2024</risdate><volume>16</volume><issue>12</issue><spage>2196</spage><pages>2196-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>Limited data exists for the efficacy and outcomes of nivolumab as a second-line treatment for unresectable hepatocellular carcinoma (uHCC). We aimed to assess the efficacy and safety of nivolumab in patients with uHCC who experienced disease progression during sorafenib treatment.
In this retrospective, observational, multicenter study, adult Child-Turcotte-Pugh A/7B patients with uHCC who tolerated sorafenib therapy but showed disease progression switched to second-line intravenous nivolumab (
= 42). A similar number of consecutive, unselected patients who were maintained on sorafenib therapy, regardless of tumoral response or progression, served as historical controls (
= 38). The primary endpoint was overall survival (OS, defined as the time from starting sorafenib in either group up to death due to any cause) and analyzed by intention-to-treat.
The mean age of the overall cohort was 72.4 ± 10.1 years, of whom 87.5% were males and 58.8% had underlying viral etiology. Patients in the two cohorts were similar, except those who received nivolumab had more co-morbidities (70.0% vs. 15.4%), ECOG-2 status (21.4% vs. 15.8%), BCLC stage C (81.0% vs. 47.4%), and extravascular invasion (54.4% vs. 21.8%) (
< 0.05 for all). More patients in the nivolumab arm were Child-Turcotte-Pugh B (35.7% vs. 21.1%,
= 0.15). Median OS was 22.2 months (95% CI: 8.9-49.8) on second-line nivolumab and 11.0 months (95% CI: 3.6-18.4) on sorafenib alone (HR 1.93; 95% CI: 1.1-3.3,
= 0.014). Median OS after starting nivolumab was 10.2 months, and time-to-progression was 4.9 months (95% CI: 3.2-6.3).
Nivolumab is an effective second-line treatment option in patients with uHCC who progress on sorafenib, with significantly improved OS. These early real-life data offer encouraging results, similar to those shown in Phase I/IIa clinical trials. Further investigations are warranted for the use of nivolumab as a monotherapy.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>38927902</pmid><doi>10.3390/cancers16122196</doi><orcidid>https://orcid.org/0000-0002-3830-9236</orcidid><orcidid>https://orcid.org/0000-0003-2017-3526</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Ascites Cancer Cancer patients Cancer therapies Care and treatment Clinical trials Comparative analysis Hepatocellular carcinoma Kinases Liver Liver cancer Liver diseases Oncology, Experimental Patient outcomes Patients Survival Toxicity Tumors |
title | Nivolumab as Second-Line Therapy Improves Survival in Patients with Unresectable Hepatocellular Carcinoma |
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