Hepatocellular Carcinoma

Key clinical point: Compared with the standard ultrasonography (US)-based imaging surveillance for hepatocellular carcinoma (HCC), intensive surveillance using alternative computed tomography (CT)/magnetic resonance imaging (MRI) in addition to US may facilitate the diagnosis of very early-stage HCC without providing any survival advantage.

Major finding: Diagnosis of very early-stage HCC was better in the low- (adjusted odds ratio [aOR] 0.44; P = .034) and high- (aOR 0.40; P = .014) intensive surveillance groups than in the standard surveillance group. However, overall survival remained unaffected by the surveillance intensity (P > .05).

Study details: This was a retrospective cohort study including 529 patients with newly diagnosed HCC who were on regular surveillance and were monitored using only US (standard group; n = 62) or CT/MRI plus US (categorized into low-intensive group [n = 232] and high-intensive group [n = 235] based on the median percentage of CT/MRI investigations [cut-off, 27%]).

Disclosures: The study did not receive any funding. The authors disclosed no conflicts of interest.

Source: Hwang JA et al. Association between intensity of imaging surveillance and clinical outcomes in patients with hepatocellular carcinoma. Eur J Radiol. 2022;151:110328 (Apr 21). Doi: 10.1016/j.ejrad.2022.110328

Key clinical point: Compared with the standard ultrasonography (US)-based imaging surveillance for hepatocellular carcinoma (HCC), intensive surveillance using alternative computed tomography (CT)/magnetic resonance imaging (MRI) in addition to US may facilitate the diagnosis of very early-stage HCC without providing any survival advantage.

Major finding: Diagnosis of very early-stage HCC was better in the low- (adjusted odds ratio [aOR] 0.44; P = .034) and high- (aOR 0.40; P = .014) intensive surveillance groups than in the standard surveillance group. However, overall survival remained unaffected by the surveillance intensity (P > .05).

Study details: This was a retrospective cohort study including 529 patients with newly diagnosed HCC who were on regular surveillance and were monitored using only US (standard group; n = 62) or CT/MRI plus US (categorized into low-intensive group [n = 232] and high-intensive group [n = 235] based on the median percentage of CT/MRI investigations [cut-off, 27%]).

Disclosures: The study did not receive any funding. The authors disclosed no conflicts of interest.

Source: Hwang JA et al. Association between intensity of imaging surveillance and clinical outcomes in patients with hepatocellular carcinoma. Eur J Radiol. 2022;151:110328 (Apr 21). Doi: 10.1016/j.ejrad.2022.110328

Key clinical point: Compared with the standard ultrasonography (US)-based imaging surveillance for hepatocellular carcinoma (HCC), intensive surveillance using alternative computed tomography (CT)/magnetic resonance imaging (MRI) in addition to US may facilitate the diagnosis of very early-stage HCC without providing any survival advantage.

Major finding: Diagnosis of very early-stage HCC was better in the low- (adjusted odds ratio [aOR] 0.44; P = .034) and high- (aOR 0.40; P = .014) intensive surveillance groups than in the standard surveillance group. However, overall survival remained unaffected by the surveillance intensity (P > .05).

Study details: This was a retrospective cohort study including 529 patients with newly diagnosed HCC who were on regular surveillance and were monitored using only US (standard group; n = 62) or CT/MRI plus US (categorized into low-intensive group [n = 232] and high-intensive group [n = 235] based on the median percentage of CT/MRI investigations [cut-off, 27%]).

Disclosures: The study did not receive any funding. The authors disclosed no conflicts of interest.

Source: Hwang JA et al. Association between intensity of imaging surveillance and clinical outcomes in patients with hepatocellular carcinoma. Eur J Radiol. 2022;151:110328 (Apr 21). Doi: 10.1016/j.ejrad.2022.110328

Key clinical point: Compared with best supportive care (BSC), treatment with any type of anticancer therapy after immune checkpoint inhibitor (ICI) therapy discontinuation in hepatocellular carcinoma (HCC) is associated with a significant improvement in overall survival.

Major finding: After ICI therapy discontinuation, patients who received anticancer therapy vs. BSC showed a significantly improved median overall survival (12.2 vs 3.2 months; hazard ratio 0.4; P < .001).

Study details: This was a retrospective, multicenter study that included 420 patients with HCC who were treated with ICI followed by subsequent anticancer treatment (n = 163) or BSC (n = 152).

Disclosures: The study was supported by the Wellcome Trust Strategic Fund, UK. Some authors declared serving as advisors, consultants, or speakers for and receiving grants from various sources.

Source: Sharma R et al. Patterns and outcomes of subsequent therapy after immune checkpoint inhibitor discontinuation in HCC. Hepatol Commun. 2022 (Apr 28). Doi: 10.1002/hep4.1927

Key clinical point: Compared with best supportive care (BSC), treatment with any type of anticancer therapy after immune checkpoint inhibitor (ICI) therapy discontinuation in hepatocellular carcinoma (HCC) is associated with a significant improvement in overall survival.

Major finding: After ICI therapy discontinuation, patients who received anticancer therapy vs. BSC showed a significantly improved median overall survival (12.2 vs 3.2 months; hazard ratio 0.4; P < .001).

Study details: This was a retrospective, multicenter study that included 420 patients with HCC who were treated with ICI followed by subsequent anticancer treatment (n = 163) or BSC (n = 152).

Disclosures: The study was supported by the Wellcome Trust Strategic Fund, UK. Some authors declared serving as advisors, consultants, or speakers for and receiving grants from various sources.

Source: Sharma R et al. Patterns and outcomes of subsequent therapy after immune checkpoint inhibitor discontinuation in HCC. Hepatol Commun. 2022 (Apr 28). Doi: 10.1002/hep4.1927

Key clinical point: Compared with best supportive care (BSC), treatment with any type of anticancer therapy after immune checkpoint inhibitor (ICI) therapy discontinuation in hepatocellular carcinoma (HCC) is associated with a significant improvement in overall survival.

Major finding: After ICI therapy discontinuation, patients who received anticancer therapy vs. BSC showed a significantly improved median overall survival (12.2 vs 3.2 months; hazard ratio 0.4; P < .001).

Study details: This was a retrospective, multicenter study that included 420 patients with HCC who were treated with ICI followed by subsequent anticancer treatment (n = 163) or BSC (n = 152).

Disclosures: The study was supported by the Wellcome Trust Strategic Fund, UK. Some authors declared serving as advisors, consultants, or speakers for and receiving grants from various sources.

Source: Sharma R et al. Patterns and outcomes of subsequent therapy after immune checkpoint inhibitor discontinuation in HCC. Hepatol Commun. 2022 (Apr 28). Doi: 10.1002/hep4.1927

Key clinical point: Pembrolizumab monotherapy showed favorable efficacy in systemic therapy-naive patients with advanced hepatocellular carcinoma (aHCC), with no new safety signals in addition to those observed for pembrolizumab in aHCC in a second-line setting.

Major finding: The objective response rate was 16% (95% CI 7%-29%), and the median duration of response was 16 months. The median progression-free and overall survival were 4 (95% CI 2-8) and 17 (95% CI 8-23) months, respectively. Only 16% of patients experienced grade ≥3 treatment-related adverse events.

Study details: Findings are from the phase 2  KEYNOTE-224 trial including 51 adult, systemic therapy-naive patients with aHCC who received 200 mg pembrolizumab intravenously every 3 weeks for up to 35 cycles.

Disclosures: The study was sponsored by Merck Sharp & Dohme Corp. (MSD), a subsidiary of Merck & Co., Inc., USA. Some authors reported being advisory board members, consultants, or advisors or receiving research grants, speaker honoraria, or travel and accommodation expenses from various sources, including MSD. The other authors are employees and stock owners of MSD.

Source: Verset G et al. Pembrolizumab monotherapy for previously untreated advanced hepatocellular carcinoma: Data from the open-label, phase II KEYNOTE-224 trial. Clin Cancer Res. 2022 (Apr 14). Doi: 10.1158/1078-0432.CCR-21-3807

Key clinical point: Pembrolizumab monotherapy showed favorable efficacy in systemic therapy-naive patients with advanced hepatocellular carcinoma (aHCC), with no new safety signals in addition to those observed for pembrolizumab in aHCC in a second-line setting.

Major finding: The objective response rate was 16% (95% CI 7%-29%), and the median duration of response was 16 months. The median progression-free and overall survival were 4 (95% CI 2-8) and 17 (95% CI 8-23) months, respectively. Only 16% of patients experienced grade ≥3 treatment-related adverse events.

Study details: Findings are from the phase 2  KEYNOTE-224 trial including 51 adult, systemic therapy-naive patients with aHCC who received 200 mg pembrolizumab intravenously every 3 weeks for up to 35 cycles.

Disclosures: The study was sponsored by Merck Sharp & Dohme Corp. (MSD), a subsidiary of Merck & Co., Inc., USA. Some authors reported being advisory board members, consultants, or advisors or receiving research grants, speaker honoraria, or travel and accommodation expenses from various sources, including MSD. The other authors are employees and stock owners of MSD.

Source: Verset G et al. Pembrolizumab monotherapy for previously untreated advanced hepatocellular carcinoma: Data from the open-label, phase II KEYNOTE-224 trial. Clin Cancer Res. 2022 (Apr 14). Doi: 10.1158/1078-0432.CCR-21-3807

Key clinical point: Pembrolizumab monotherapy showed favorable efficacy in systemic therapy-naive patients with advanced hepatocellular carcinoma (aHCC), with no new safety signals in addition to those observed for pembrolizumab in aHCC in a second-line setting.

Major finding: The objective response rate was 16% (95% CI 7%-29%), and the median duration of response was 16 months. The median progression-free and overall survival were 4 (95% CI 2-8) and 17 (95% CI 8-23) months, respectively. Only 16% of patients experienced grade ≥3 treatment-related adverse events.

Study details: Findings are from the phase 2  KEYNOTE-224 trial including 51 adult, systemic therapy-naive patients with aHCC who received 200 mg pembrolizumab intravenously every 3 weeks for up to 35 cycles.

Disclosures: The study was sponsored by Merck Sharp & Dohme Corp. (MSD), a subsidiary of Merck & Co., Inc., USA. Some authors reported being advisory board members, consultants, or advisors or receiving research grants, speaker honoraria, or travel and accommodation expenses from various sources, including MSD. The other authors are employees and stock owners of MSD.

Source: Verset G et al. Pembrolizumab monotherapy for previously untreated advanced hepatocellular carcinoma: Data from the open-label, phase II KEYNOTE-224 trial. Clin Cancer Res. 2022 (Apr 14). Doi: 10.1158/1078-0432.CCR-21-3807

Key clinical point: Compared with liver-directed ablative therapies, orthotopic liver transplantation (OLT) offers a survival advantage for elderly patients with early-stage hepatocellular carcinoma (HCC) and alpha-fetoprotein (AFP) levels <500 ng/mL.

Major finding: Multivariable analysis revealed a significant survival benefit of OLT compared with ablative therapy alone (adjusted hazard ratio [aHR] 0.31; P < .001), with OLT being associated with better survival even after adjusting for imbalanced factors after propensity matching (aHR 0.35; P < .001).

Study details: The data come from a retrospective review study that propensity score matched patients aged ≥70 years with stage I-II HCC and AFP levels of <500 ng/mL receiving OLT (n = 170) with those undergoing liver-directed ablative therapy (n = 170).

Disclosures: No source of funding or conflicts of interest was declared by the authors.

Source: Shah MB et al. Outcomes in elderly patients undergoing liver transplantation compared with liver-directed ablative therapy in early-stage hepatocellular carcinoma. J Am Coll Surg. 2022;234(5):892-899 (Apr 15). Doi: 10.1097/XCS.0000000000000135

Key clinical point: Compared with liver-directed ablative therapies, orthotopic liver transplantation (OLT) offers a survival advantage for elderly patients with early-stage hepatocellular carcinoma (HCC) and alpha-fetoprotein (AFP) levels <500 ng/mL.

Major finding: Multivariable analysis revealed a significant survival benefit of OLT compared with ablative therapy alone (adjusted hazard ratio [aHR] 0.31; P < .001), with OLT being associated with better survival even after adjusting for imbalanced factors after propensity matching (aHR 0.35; P < .001).

Study details: The data come from a retrospective review study that propensity score matched patients aged ≥70 years with stage I-II HCC and AFP levels of <500 ng/mL receiving OLT (n = 170) with those undergoing liver-directed ablative therapy (n = 170).

Disclosures: No source of funding or conflicts of interest was declared by the authors.

Source: Shah MB et al. Outcomes in elderly patients undergoing liver transplantation compared with liver-directed ablative therapy in early-stage hepatocellular carcinoma. J Am Coll Surg. 2022;234(5):892-899 (Apr 15). Doi: 10.1097/XCS.0000000000000135

Key clinical point: Compared with liver-directed ablative therapies, orthotopic liver transplantation (OLT) offers a survival advantage for elderly patients with early-stage hepatocellular carcinoma (HCC) and alpha-fetoprotein (AFP) levels <500 ng/mL.

Major finding: Multivariable analysis revealed a significant survival benefit of OLT compared with ablative therapy alone (adjusted hazard ratio [aHR] 0.31; P < .001), with OLT being associated with better survival even after adjusting for imbalanced factors after propensity matching (aHR 0.35; P < .001).

Study details: The data come from a retrospective review study that propensity score matched patients aged ≥70 years with stage I-II HCC and AFP levels of <500 ng/mL receiving OLT (n = 170) with those undergoing liver-directed ablative therapy (n = 170).

Disclosures: No source of funding or conflicts of interest was declared by the authors.

Source: Shah MB et al. Outcomes in elderly patients undergoing liver transplantation compared with liver-directed ablative therapy in early-stage hepatocellular carcinoma. J Am Coll Surg. 2022;234(5):892-899 (Apr 15). Doi: 10.1097/XCS.0000000000000135

Key clinical point: Transjugular intrahepatic portosystemic shunt (TIPS) plus sequential systemic therapy is safe and feasible for treating portal vein tumor thrombus (PVTT)-related symptomatic portal hypertension (SPH) in advanced hepatocellular carcinoma (aHCC) and may supplement current aHCC treatments.

Major finding: TIPS plus sequential systemic therapy vs only symptomatic and supportive treatment showed a significantly lower variceal rebleeding rate (5.0% vs 73.7%; P < .001) and a significantly higher median overall survival (9.6 vs 4.9 months; P < .001).

Study details: This retrospective study propensity score matched patients with aHCC and PVTT-related SPH who received TIPS plus sequential systemic therapy (n = 42) with those who received only symptomatic and supportive treatment (n = 42).

Disclosures: This study was funded by the National Natural Science Foundation of China, Science and Technology Planning Project of Guangdong Province, and Medical Science and Technology Foundation of Guangdong Province. The authors declared no conflicts of interest.

Source: Qiu Z et al. TIPS plus sequential systemic therapy of advanced HCC patients with tumour thrombus-related symptomatic portal hypertension. Eur Radiol. 2022 (Apr 20). Doi: 10.1007/s00330-022-08705-7

Key clinical point: Transjugular intrahepatic portosystemic shunt (TIPS) plus sequential systemic therapy is safe and feasible for treating portal vein tumor thrombus (PVTT)-related symptomatic portal hypertension (SPH) in advanced hepatocellular carcinoma (aHCC) and may supplement current aHCC treatments.

Major finding: TIPS plus sequential systemic therapy vs only symptomatic and supportive treatment showed a significantly lower variceal rebleeding rate (5.0% vs 73.7%; P < .001) and a significantly higher median overall survival (9.6 vs 4.9 months; P < .001).

Study details: This retrospective study propensity score matched patients with aHCC and PVTT-related SPH who received TIPS plus sequential systemic therapy (n = 42) with those who received only symptomatic and supportive treatment (n = 42).

Disclosures: This study was funded by the National Natural Science Foundation of China, Science and Technology Planning Project of Guangdong Province, and Medical Science and Technology Foundation of Guangdong Province. The authors declared no conflicts of interest.

Source: Qiu Z et al. TIPS plus sequential systemic therapy of advanced HCC patients with tumour thrombus-related symptomatic portal hypertension. Eur Radiol. 2022 (Apr 20). Doi: 10.1007/s00330-022-08705-7

Key clinical point: Transjugular intrahepatic portosystemic shunt (TIPS) plus sequential systemic therapy is safe and feasible for treating portal vein tumor thrombus (PVTT)-related symptomatic portal hypertension (SPH) in advanced hepatocellular carcinoma (aHCC) and may supplement current aHCC treatments.

Major finding: TIPS plus sequential systemic therapy vs only symptomatic and supportive treatment showed a significantly lower variceal rebleeding rate (5.0% vs 73.7%; P < .001) and a significantly higher median overall survival (9.6 vs 4.9 months; P < .001).

Study details: This retrospective study propensity score matched patients with aHCC and PVTT-related SPH who received TIPS plus sequential systemic therapy (n = 42) with those who received only symptomatic and supportive treatment (n = 42).

Disclosures: This study was funded by the National Natural Science Foundation of China, Science and Technology Planning Project of Guangdong Province, and Medical Science and Technology Foundation of Guangdong Province. The authors declared no conflicts of interest.

Source: Qiu Z et al. TIPS plus sequential systemic therapy of advanced HCC patients with tumour thrombus-related symptomatic portal hypertension. Eur Radiol. 2022 (Apr 20). Doi: 10.1007/s00330-022-08705-7

Key clinical point: Among patients with hepatitis C virus (HCV) who achieved a sustained virologic response (SVR) after direct-acting antiviral (DAA) therapy, those with cirrhosis showed an extremely high incidence of hepatocellular carcinoma (HCC).

Major finding: The incidence of HCC in patients with cirrhosis was 2.99 per 100 person-years (95% CI 2.52-3.54), whereas that in patients without cirrhosis was 0.47 per 100 person-years (95% CI 0.32-0.70).

Study details: This was a meta-analysis of 42 studies including 59,834 adult patients with HCV who achieved SVR after DAA therapy and were categorized into those with (n = 27,711; 31 studies) or without (n = 32,123; 11 studies) cirrhosis.

Disclosures: This study was funded by the US National Institutes of Health. The authors declared no conflict of interests.

Source: Kim NJ et al. Fibrosis-stage specific incidence of hepatocellular cancer after hepatitis C cure with direct-acting antivirals: A systematic review & meta-analysis. Clin Gastroenterol Hepatol. 2022 (May 4). Doi: 10.1016/j.cgh.2022.04.013

Key clinical point: Among patients with hepatitis C virus (HCV) who achieved a sustained virologic response (SVR) after direct-acting antiviral (DAA) therapy, those with cirrhosis showed an extremely high incidence of hepatocellular carcinoma (HCC).

Major finding: The incidence of HCC in patients with cirrhosis was 2.99 per 100 person-years (95% CI 2.52-3.54), whereas that in patients without cirrhosis was 0.47 per 100 person-years (95% CI 0.32-0.70).

Study details: This was a meta-analysis of 42 studies including 59,834 adult patients with HCV who achieved SVR after DAA therapy and were categorized into those with (n = 27,711; 31 studies) or without (n = 32,123; 11 studies) cirrhosis.

Disclosures: This study was funded by the US National Institutes of Health. The authors declared no conflict of interests.

Source: Kim NJ et al. Fibrosis-stage specific incidence of hepatocellular cancer after hepatitis C cure with direct-acting antivirals: A systematic review & meta-analysis. Clin Gastroenterol Hepatol. 2022 (May 4). Doi: 10.1016/j.cgh.2022.04.013

Key clinical point: Among patients with hepatitis C virus (HCV) who achieved a sustained virologic response (SVR) after direct-acting antiviral (DAA) therapy, those with cirrhosis showed an extremely high incidence of hepatocellular carcinoma (HCC).

Major finding: The incidence of HCC in patients with cirrhosis was 2.99 per 100 person-years (95% CI 2.52-3.54), whereas that in patients without cirrhosis was 0.47 per 100 person-years (95% CI 0.32-0.70).

Study details: This was a meta-analysis of 42 studies including 59,834 adult patients with HCV who achieved SVR after DAA therapy and were categorized into those with (n = 27,711; 31 studies) or without (n = 32,123; 11 studies) cirrhosis.

Disclosures: This study was funded by the US National Institutes of Health. The authors declared no conflict of interests.

Source: Kim NJ et al. Fibrosis-stage specific incidence of hepatocellular cancer after hepatitis C cure with direct-acting antivirals: A systematic review & meta-analysis. Clin Gastroenterol Hepatol. 2022 (May 4). Doi: 10.1016/j.cgh.2022.04.013

Key clinical point: Tumor vaccines are effective and safe in patients with hepatocellular carcinoma (HCC).

Major finding: Tumor vaccines effectuated a pooled objective response rate, median overall survival, and median progression-free survival of 7% (95% CI 3%-14%), 13.7 (95% CI 8.2-22.8) months, and 6.2 (95% CI 3.0-12.9) months, respectively. The pooled rate of severe adverse events (AE; grades 3-5) was only 7.9%, and the most prevalent AE was grade 1-2 injection site reaction.

Study details: This was a meta-analysis of 35 cohorts in 31 studies (published between 2001 and 2021) that included 932 patients with HCC who received tumor vaccines.

Disclosures: The study was supported by the Taishan Scholars Program for Young Expert of Shandong Province and National Natural Science Foundation of China, among others. The authors declared no conflicts of interest.

Source: Han CL et al. Efficacy and security of tumor vaccines for hepatocellular carcinoma: A systemic review and meta-analysis of the last 2 decades. J Cancer Res Clin Oncol. 2022 (Apr 28). Doi: 10.1007/s00432-022-04008-y

Key clinical point: Tumor vaccines are effective and safe in patients with hepatocellular carcinoma (HCC).

Major finding: Tumor vaccines effectuated a pooled objective response rate, median overall survival, and median progression-free survival of 7% (95% CI 3%-14%), 13.7 (95% CI 8.2-22.8) months, and 6.2 (95% CI 3.0-12.9) months, respectively. The pooled rate of severe adverse events (AE; grades 3-5) was only 7.9%, and the most prevalent AE was grade 1-2 injection site reaction.

Study details: This was a meta-analysis of 35 cohorts in 31 studies (published between 2001 and 2021) that included 932 patients with HCC who received tumor vaccines.

Disclosures: The study was supported by the Taishan Scholars Program for Young Expert of Shandong Province and National Natural Science Foundation of China, among others. The authors declared no conflicts of interest.

Source: Han CL et al. Efficacy and security of tumor vaccines for hepatocellular carcinoma: A systemic review and meta-analysis of the last 2 decades. J Cancer Res Clin Oncol. 2022 (Apr 28). Doi: 10.1007/s00432-022-04008-y

Key clinical point: Tumor vaccines are effective and safe in patients with hepatocellular carcinoma (HCC).

Major finding: Tumor vaccines effectuated a pooled objective response rate, median overall survival, and median progression-free survival of 7% (95% CI 3%-14%), 13.7 (95% CI 8.2-22.8) months, and 6.2 (95% CI 3.0-12.9) months, respectively. The pooled rate of severe adverse events (AE; grades 3-5) was only 7.9%, and the most prevalent AE was grade 1-2 injection site reaction.

Study details: This was a meta-analysis of 35 cohorts in 31 studies (published between 2001 and 2021) that included 932 patients with HCC who received tumor vaccines.

Disclosures: The study was supported by the Taishan Scholars Program for Young Expert of Shandong Province and National Natural Science Foundation of China, among others. The authors declared no conflicts of interest.

Source: Han CL et al. Efficacy and security of tumor vaccines for hepatocellular carcinoma: A systemic review and meta-analysis of the last 2 decades. J Cancer Res Clin Oncol. 2022 (Apr 28). Doi: 10.1007/s00432-022-04008-y

Key clinical point: Lenvatinib plus nivolumab shows a promising efficacy and safety profile against advanced hepatocellular carcinoma (HCC) in the real-world setting.

Major finding: The lenvatinib plus nivolumab vs lenvatinib group showed a higher objective response rate (45.0% vs 23.4%; P = .03) and longer progression-free survival (7.5 vs 4.8 months; P = .05) and overall survival (22.9 vs 10.3 months; P = .01). Only a few patients developed grade 3/4 toxicities, such as dermatitis (15.0%), gastrointestinal bleeding (7.5%), and hypertension (5.0%).

Study details: This was a retrospective study including 87 patients aged ≥20 years with advanced HCC who received lenvatinib plus nivolumab (n = 40) or lenvatinib alone (n = 47).

Disclosures: The study was funded by the Ministry of Health and Welfare and the Center of Excellence for Cancer Research and Taipei Veterans General Hospital. The authors declared no conflicts if interest.

Source: Wu W-C et al. Lenvatinib combined with nivolumab in advanced hepatocellular carcinoma-real-world experience. Invest New Drugs. 2022 (Apr 28). Doi: 10.1007/s10637-022-01248-0

Key clinical point: Lenvatinib plus nivolumab shows a promising efficacy and safety profile against advanced hepatocellular carcinoma (HCC) in the real-world setting.

Major finding: The lenvatinib plus nivolumab vs lenvatinib group showed a higher objective response rate (45.0% vs 23.4%; P = .03) and longer progression-free survival (7.5 vs 4.8 months; P = .05) and overall survival (22.9 vs 10.3 months; P = .01). Only a few patients developed grade 3/4 toxicities, such as dermatitis (15.0%), gastrointestinal bleeding (7.5%), and hypertension (5.0%).

Study details: This was a retrospective study including 87 patients aged ≥20 years with advanced HCC who received lenvatinib plus nivolumab (n = 40) or lenvatinib alone (n = 47).

Disclosures: The study was funded by the Ministry of Health and Welfare and the Center of Excellence for Cancer Research and Taipei Veterans General Hospital. The authors declared no conflicts if interest.

Source: Wu W-C et al. Lenvatinib combined with nivolumab in advanced hepatocellular carcinoma-real-world experience. Invest New Drugs. 2022 (Apr 28). Doi: 10.1007/s10637-022-01248-0

Key clinical point: Lenvatinib plus nivolumab shows a promising efficacy and safety profile against advanced hepatocellular carcinoma (HCC) in the real-world setting.

Major finding: The lenvatinib plus nivolumab vs lenvatinib group showed a higher objective response rate (45.0% vs 23.4%; P = .03) and longer progression-free survival (7.5 vs 4.8 months; P = .05) and overall survival (22.9 vs 10.3 months; P = .01). Only a few patients developed grade 3/4 toxicities, such as dermatitis (15.0%), gastrointestinal bleeding (7.5%), and hypertension (5.0%).

Study details: This was a retrospective study including 87 patients aged ≥20 years with advanced HCC who received lenvatinib plus nivolumab (n = 40) or lenvatinib alone (n = 47).

Disclosures: The study was funded by the Ministry of Health and Welfare and the Center of Excellence for Cancer Research and Taipei Veterans General Hospital. The authors declared no conflicts if interest.

Source: Wu W-C et al. Lenvatinib combined with nivolumab in advanced hepatocellular carcinoma-real-world experience. Invest New Drugs. 2022 (Apr 28). Doi: 10.1007/s10637-022-01248-0

Key clinical point: Immunotherapy was associated with prolonged survival compared with chemotherapy in patients with advanced hepatocellular carcinoma (HCC).

Major finding: After adjusting for confounding variables, immunotherapy was independently associated with improved overall survival (adjusted hazard ratio 0.76; 95% CI 0.65-0.88) compared with chemotherapy.

Study details: Findings are from a retrospective cohort study that included 3990 patients with advanced HCC (tumor-node-metastasis stage III or IV) from the National Cancer Database who received chemotherapy (n = 3248) or immunotherapy (n = 742) as the first-line systemic treatment.

Disclosures: No funding source was reported. Some authors declared serving as consultants or advisors or receiving institutional research support from various organizations.

Source: Ahn JC et al. Racial and ethnic disparities in early treatment with immunotherapy for advanced HCC in the United States. Hepatology. 2022 (Apr 16). Doi: 10.1002/hep.32527

Key clinical point: Immunotherapy was associated with prolonged survival compared with chemotherapy in patients with advanced hepatocellular carcinoma (HCC).

Major finding: After adjusting for confounding variables, immunotherapy was independently associated with improved overall survival (adjusted hazard ratio 0.76; 95% CI 0.65-0.88) compared with chemotherapy.

Study details: Findings are from a retrospective cohort study that included 3990 patients with advanced HCC (tumor-node-metastasis stage III or IV) from the National Cancer Database who received chemotherapy (n = 3248) or immunotherapy (n = 742) as the first-line systemic treatment.

Disclosures: No funding source was reported. Some authors declared serving as consultants or advisors or receiving institutional research support from various organizations.

Source: Ahn JC et al. Racial and ethnic disparities in early treatment with immunotherapy for advanced HCC in the United States. Hepatology. 2022 (Apr 16). Doi: 10.1002/hep.32527

Key clinical point: Immunotherapy was associated with prolonged survival compared with chemotherapy in patients with advanced hepatocellular carcinoma (HCC).

Major finding: After adjusting for confounding variables, immunotherapy was independently associated with improved overall survival (adjusted hazard ratio 0.76; 95% CI 0.65-0.88) compared with chemotherapy.

Study details: Findings are from a retrospective cohort study that included 3990 patients with advanced HCC (tumor-node-metastasis stage III or IV) from the National Cancer Database who received chemotherapy (n = 3248) or immunotherapy (n = 742) as the first-line systemic treatment.

Disclosures: No funding source was reported. Some authors declared serving as consultants or advisors or receiving institutional research support from various organizations.

Source: Ahn JC et al. Racial and ethnic disparities in early treatment with immunotherapy for advanced HCC in the United States. Hepatology. 2022 (Apr 16). Doi: 10.1002/hep.32527

Key clinical point: As laparoscopic anatomical hepatectomy (LAH) is associated with increased disease-free survival (DFS) and comparable long-term overall survival (OS) and postoperative complications compared with non-anatomical hepatectomy (LNAH), it is recommended over LNAH for selected patients with HCC.

Major finding: Patients who underwent LAH vs LNAH showed significantly higher 5-year DFS rate (33.9% vs 30.1%; P = .009) and comparable long-term OS (43.2% vs 35.2%; P = .054) and postoperative complication (8.9% vs 12.4%; P = .255) rates.

Study details: Findings are from a single-center, prospective randomized controlled trial including 385 adult patients with HCC (single tumor ≤10 cm in size) who were randomly assigned to undergo LAH (n = 192) or LNAH (n = 193).

Disclosures: The study was sponsored by the National Natural Science Foundation of China and Project of Chongqing Municipality. The authors reported no conflicts of interest.

Source: Liao K et al. Laparoscopic anatomical versus non-anatomical hepatectomy in the treatment of hepatocellular carcinoma: A randomised controlled trial. Int J Surg. 2022;102:106652 (May 4). Doi: 10.1016/j.ijsu.2022.106652

Key clinical point: As laparoscopic anatomical hepatectomy (LAH) is associated with increased disease-free survival (DFS) and comparable long-term overall survival (OS) and postoperative complications compared with non-anatomical hepatectomy (LNAH), it is recommended over LNAH for selected patients with HCC.

Major finding: Patients who underwent LAH vs LNAH showed significantly higher 5-year DFS rate (33.9% vs 30.1%; P = .009) and comparable long-term OS (43.2% vs 35.2%; P = .054) and postoperative complication (8.9% vs 12.4%; P = .255) rates.

Study details: Findings are from a single-center, prospective randomized controlled trial including 385 adult patients with HCC (single tumor ≤10 cm in size) who were randomly assigned to undergo LAH (n = 192) or LNAH (n = 193).

Disclosures: The study was sponsored by the National Natural Science Foundation of China and Project of Chongqing Municipality. The authors reported no conflicts of interest.

Source: Liao K et al. Laparoscopic anatomical versus non-anatomical hepatectomy in the treatment of hepatocellular carcinoma: A randomised controlled trial. Int J Surg. 2022;102:106652 (May 4). Doi: 10.1016/j.ijsu.2022.106652

Key clinical point: As laparoscopic anatomical hepatectomy (LAH) is associated with increased disease-free survival (DFS) and comparable long-term overall survival (OS) and postoperative complications compared with non-anatomical hepatectomy (LNAH), it is recommended over LNAH for selected patients with HCC.

Major finding: Patients who underwent LAH vs LNAH showed significantly higher 5-year DFS rate (33.9% vs 30.1%; P = .009) and comparable long-term OS (43.2% vs 35.2%; P = .054) and postoperative complication (8.9% vs 12.4%; P = .255) rates.

Study details: Findings are from a single-center, prospective randomized controlled trial including 385 adult patients with HCC (single tumor ≤10 cm in size) who were randomly assigned to undergo LAH (n = 192) or LNAH (n = 193).

Disclosures: The study was sponsored by the National Natural Science Foundation of China and Project of Chongqing Municipality. The authors reported no conflicts of interest.

Source: Liao K et al. Laparoscopic anatomical versus non-anatomical hepatectomy in the treatment of hepatocellular carcinoma: A randomised controlled trial. Int J Surg. 2022;102:106652 (May 4). Doi: 10.1016/j.ijsu.2022.106652