The use of neoadjuvant transarterial infusion before hepatectomy showed a significant improvement in overall survival (OS) and progression-free survival (PFS) (p=0.016 and 0.017, respectively) for resectable Barcelona Clinic Liver Cancer (BCLC) stage A/B hepatocellular carcinoma (HCC) patients beyond Milan criteria.11. Li SH, et al J Clin Oncol 39, 2021 (suppl 15; abstr 4008) In the neoadjuvant setting, camrelizumab in combination with apatinib for advanced HCC patients also demonstrated an improvement in major pathologic response (MPR) of 29.4%.22. Xia YX, et al J Clin Oncol 39, 2021 (suppl 15; abstr 4082)
In the first-line the results of a number of trials were reported. Icaritin significantly improved median overall survival (mOS) over huachashu in composite biomarker score-positive (composite biomarker score) patients with combined risk/poor prognosis factors such as BCLC stage C, hepatitis B virus infection and thrombocytopenia, with a reported mOS of 13.54 months vs 7.06 months (HR=0.40; 95% CI: 0.21-0.77; p=0.0046).33. Sun Y, et al J Clin Oncol 39, 2021 (suppl 15; abstr 4077) The combination treatment of lenvatinib and AK104 also showed a promising anti-tumour effect with an overall response rate (ORR) of 44.4% and disease control rate (DCR) of 77.8%.44. Bai L, et al J Clin Oncol 39, 2021 (suppl 15; abstr 4101) Lenvatinib was also used as first-line in combination with toripalimab plus hepatic arterial infusion chemotherapy (HAIC) in advanced HCC patients, with a 6-month PFS of 80.6%, median progression-free survival (mPFS) of 10.5 months (95% CI: 6.21−14.79) and ORR of 63.9% (95% CI: 40.9−73.0), denoting anti-tumour activity.55. He MK, et al J Clin Oncol 39, 2021 (suppl 15; abstr 4083) In the IMbrave 150 trial, the combination of atezolizumab plus bevacizumab reported an improved OS (HR=0.62; 95% CI: 0.34-1.11) and PFS (HR=0.62; 95% CI: 0.35-1.09) over sorafenib.66. Breder VV, et al J Clin Oncol 39, 2021 (suppl 15; abstr 4073) Exploratory analysis demonstrated responders have not shown any landmarks (HR=0.02; 95% CI: 26.2-NE)77. Ducreux M, et al J Clin Oncol 39, 2021 (suppl 15; abstr 4071)
In the KEYNOTE-224 and -240 trials, pembrolizumab was evaluated as both first- and second-line treatment, and demonstrated a consistent improvement and benefit:risk profile. In the first-line single-arm treatment, a mOS of 17 months (95% CI: 8-NA), median time to progression (mTTP) and mPFS of 4 months (95% CI: 3-8; 95% CI: 2-6) were reported, suggesting a long-lasting anti-tumour effect.88. Laethem JLV, et al J Clin Oncol 39, 2021 (suppl 15; abstr 4074) Pembrolizumab was also evaluated in advanced HCC patients previously treated with sorafenib, and an OS and PFS of 13.9 months and 3.3 months (95% CI: 2.8-4.1), respectively, was recorded over placebo. Although statistical significance was not reached, results support the safety and benefit:risk profile of pembrolizumab.99. Finn RS, et al J Clin Oncol 39, 2021 (suppl 15; abstr 4072)
When used in first- and second-line treatments, the combination of camrelizumab and apatinib demonstrated a prolonged OS of 20.1 months (95% CI: 14.9-NR) and 21.8 months (95% CI: 17.3-26.8) respectively, suggesting that this is a promising combination therapy in advanced HCC patients.1010. Zhang Y, et al J Clin Oncol 39, 2021 (suppl 15; abstr 4076)
FOLFOX-based HAIC regimens (HAIC-FO) chemotherapy was compared against sorafenib on patients with intrahepatic tumour and showed a longer mOS of 13.9 months (95% CI: 10.6-17.2) over sorafenib with 8.2 months (95% CI: 7.5-9.0), indicating that HAIC-FO may be a more superior option over sorafenib for patients with heavy intrahepatic tumour burden.1111. Lyu N, et al J Clin Oncol 39, 2021 (suppl 15; abstr 4007)
Do you like our content? Subscribe to our non-intrusive newsletter today! We promise we won’t be spammy.
YOU MAY ALSO LIKE
This article is not medical advice. Patients should seek personal assessment by a licenced specialist. Physicians are recommended to read the full publication(s) as cited in the article before making medical decisions. This article does not supersede nor replace the published article(s).