Combination therapy with PD-1 blockade and radiofrequency ablation for recurrent hepatocellular carcinoma: a propensity score matching analysis

Wang, Xiaofei; Guo, Liu; Chen, Shu; Bi, Hong‐Yan; Xia, Feng; Feng, Kai; Ma, Kui; Ni, Bing

doi:10.1080/02656736.2021.1991011

Cited by 29 publications

(23 citation statements)

References 42 publications

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“…Stereotactic body radiotherapy (SBRT) combined with ICIs was reported to have an impressive tumor control capability for patients with unresectable HCC of large tumors (26). In addition, propensity score matching (PSM) analysis suggested that bigeminal therapy with PD-1 blockade plus radiofrequency ablation (RFA) was superior to RFA alone for the long-term survival of recurrent HCC patients (27).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of transarterial chemoembolization plus antiangiogenic- targeted therapy and immune checkpoint inhibitors for unresectable hepatocellular carcinoma with portal vein tumor thrombus in the real world

Feng

Liu

et al. 2022

Front. Oncol.

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PurposeThis study aimed to assess the efficacy and safety of a triple therapy that comprises transarterial chemoembolization (TACE), antiangiogenic-targeted therapy, and programmed death-1 (PD-1) inhibitors in a real-world cohort of patients with unresectable hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).MethodsConsecutive patients treated with TACE combined with antiangiogenic therapy and PD-1 inhibitors at the Eastern Hepatobiliary Surgery Hospital between June 2019 and May 2021 were enrolled. The baseline characteristics and treatment course of the patients were recorded. The tumor response was evaluated based on the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and HCC-specific modified RECIST (mRECIST). The overall survival (OS) and progression-free survival (PFS) of the patients were analyzed using the Kaplan–Meier method. Adverse events (AEs) were assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0.ResultsAs of the data cutoff on 30 August 2021, the median follow-up time was 10.0 (3.9–28.4) months. A total of 39 eligible patients were included. The objective response rate (ORR) and the disease control rate (DCR) were 35.9% and 74.4% according to the RECIST 1.1, and 48.7% and 84.6% according to mRECIST criteria, respectively. The median OS and PFS were 14.0 and 9.2 months, respectively. Moreover, 34 (87.2%) patients experienced at least one treatment-related AE and 8 (20.5%) patients experienced grade 3/4 treatment-related AEs. The most common treatment- and laboratory-related AEs were hypertension (46.2%) and decreased albumin (53.8%), respectively. No treatment-related mortality occurred during the study period.ConclusionsTACE combined with antiangiogenic-targeted therapy and immune checkpoint inhibitors may have promising anticancer activity in unresectable HCC patients with PVTT. AEs were manageable, with no unexpected overlapping toxicities.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of transarterial chemoembolization plus antiangiogenic- targeted therapy and immune checkpoint inhibitors for unresectable hepatocellular carcinoma with portal vein tumor thrombus in the real world

Feng

Liu

et al. 2022

Front. Oncol.

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“…Based on the results of CheckMate-040 and KEYNOTE-224, nivolumab and pembrolizumab, two immune checkpoint inhibitors (ICIs) causing a PD-1 blockade, were approved as second-line therapy for patients with HCC after sorafenib failure. Interestingly, a propensity score matching analysis of recurrent HCC revealed that combination therapy with anti-PD-1 inhibitors (initially administered within 72 hours of RFA) and RFA resulted in longer RFA and OS than RFA alone (19) (20). In contrast to previous studies, the median OS rate of patients treated with RFA was 9.2 months (95% CI: 6.6-11.2 months).…”

Section: Current Status Of and Challenges With This Combination Therapymentioning

confidence: 82%

A well-matched marriage of immunotherapy and radiofrequency ablation to reduce the relapse and progression of hepatocellular carcinoma

Liao

Song

Duan

et al. 2022

BST

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Hepatocellular carcinoma (HCC) is one of the most common malignancies with typical immunogenic tumor characteristics, and it develops most frequently in the context of chronic hepatitis virus infection and cirrhosis (1). Although surgical resection and liver transplantation are potentially curative options for patients with earlystage HCC, the high rate of tumor recurrence limits long-term survival (2). A point worth noting is that treatment with radiofrequency ablation (RFA) is widely accepted as a first-line therapeutic approach for early HCC, and its advantages are a high level of efficacy, a low incidence of complications, and low cost. Compared to surgery, RFA alone has a discouraging 5-year survival rate, with a high rate of HCC recurrence as the main problem post-ablation, and particularly for tumors more than 2-3 cm in size (3). To resolve this dilemma, recent efforts have focused on a combination of RFA and immunotherapy as a multimodal treatment strategy. So far, there is a lack of reliable comparative clinical data as to whether immunotherapy could really reduce additional sessions of RFA to treat HCC and halt cancer progression. Therefore, the current recommendations for combined strategies involving RFA and distinct immunotherapies need to be devised for this deadly disease, and the long-term effects of this promising approach need to be validated further.

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“…In a proof-of-concept study (NCT03939975), radiofrequency or microwave ablation successfully increased response rates from 10% to 24% in patients undergoing therapy with nivolumab or pembrolizumab who exhibited stable disease or atypical progressive disease; toxicity was tolerated and there was a relative improvement in median survival[ 59 ]. Vice versa, immunotherapy may also be used as an adjunct to radiofrequency ablation, with one study demonstrating superior survival from anti-PD-1 (camrelizumab) immunotherapy and radiofrequency ablation compared to radiofrequency ablation monotherapy[ 60 ]. Evidence from a phase II trial (NCT01853618) in patients receiving anti-CTLA-4 immunotherapy with tremelimumab supports the added benefit from combination with radiofrequency ablation or TACE[ 61 ].…”

Section: Immune Checkpoint Inhibitors In Hccmentioning

confidence: 99%

Immunotherapy for advanced hepatocellular carcinoma: From clinical trials to real-world data and future advances

Rallis¹,

Makrakis²,

Ziogas³

et al. 2022

WJCO

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Hepatocellular carcinoma (HCC) is a leading cause of cancer-associated mortality worldwide. HCC is an inflammation-associated immunogenic cancer that frequently arises in chronically inflamed livers. Advanced HCC is managed with systemic therapies; the tyrosine kinase inhibitor (TKI) sorafenib has been used in 1 st -line setting since 2007. Immunotherapies have emerged as promising treatments across solid tumors including HCC for which immune checkpoint inhibitors (ICIs) are licensed in 1 st - and 2 nd -line treatment setting. The treatment field of advanced HCC is continuously evolving. Several clinical trials are investigating novel ICI candidates as well as new ICI regimens in combination with other therapeutic modalities including systemic agents, such as other ICIs, TKIs, and anti-angiogenics. Novel immunotherapies including adoptive cell transfer, vaccine-based approaches, and virotherapy are also being brought to the fore. Yet, despite advances, several challenges persist. Lack of real-world data on the use of immunotherapy for advanced HCC in patients outside of clinical trials constitutes a main limitation hindering the breadth of application and generalizability of data to this larger and more diverse patient cohort. Consequently, issues encountered in real-world practice include patient ineligibly for immunotherapy because of contraindications, comorbidities, or poor performance status; lack of response, efficacy, and safety data; and cost-effectiveness. Further real-world data from high-quality large prospective cohort studies of immunotherapy in patients with advanced HCC is mandated to aid evidence-based clinical decision-making. This review provides a critical and comprehensive overview of clinical trials and real-world data of immunotherapy for HCC, with a focus on ICIs, as well as novel immunotherapy strategies underway.

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Combination therapy with PD-1 blockade and radiofrequency ablation for recurrent hepatocellular carcinoma: a propensity score matching analysis

Cited by 29 publications

References 42 publications

Efficacy and safety of transarterial chemoembolization plus antiangiogenic- targeted therapy and immune checkpoint inhibitors for unresectable hepatocellular carcinoma with portal vein tumor thrombus in the real world

Efficacy and safety of transarterial chemoembolization plus antiangiogenic- targeted therapy and immune checkpoint inhibitors for unresectable hepatocellular carcinoma with portal vein tumor thrombus in the real world

A well-matched marriage of immunotherapy and radiofrequency ablation to reduce the relapse and progression of hepatocellular carcinoma

Immunotherapy for advanced hepatocellular carcinoma: From clinical trials to real-world data and future advances

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