Hepatocellular Carcinoma

Hatanaka and colleagues investigated whether the etiology of the underlying liver disease affected the efficacy of atezolizumab and bevacizumab (A/B). They reported the results of a retrospective cohort study of 323 patients with Barcelona Clinic Liver Cancer (BCLC) stage B or C hepatocellular carcinoma and Child-Pugh class A cirrhosis who started A/B between September 2020 and December 2021. Patients with viral infection were defined as those who were either serum anti–hepatitis C antibody (anti-HCV Ab)- or hepatitis B surface antigen (HBs-Ag)-positive, while patients with nonviral infection was defined as those who were both serum anti-HCV Ab- and HBs-Ag-negative. After propensity matching, no significant difference in response rate ([RR] 20.6% vs 24.6% in viral and nonviral patients), disease control rate (68.3% vs 69.0%), progression-free survival ([PFS] 7.0 months vs 6.2 months), or 12-month overall survival ([OS] 65.5% vs 71.7%) was seen. The authors concluded that the underlying etiology of liver disease in patients with HCC does not affect the response to treatment with A/B.

Scheiner and colleagues evaluated the efficacy of immunotherapy in patients with HCC who had already received immune checkpoint inhibitors (ICI) in a previous line of therapy. The authors reported the results of an international, retrospective multicenter study of 58 patients with HCC who received at least two lines of ICI-based therapies. The first ICI was discontinued due to disease progression in 90%. Nonetheless, the RR to the second ICI was 26% (compared with 22% for the first ICI), with a time-to-progression (TTP) of 5.4 months (95% CI, 3.0-7.7) for the first ICI and 5.2 months (95% CI, 3.3-7.0) for the second ICI. Grade 3/4 treatment-related adverse events were observed in 16% and 17% of patients with the first and second ICI, respectively. Therefore, the authors believe that ICI rechallenge is safe and results in a treatment benefit for a similar proportion of HCC patients, as is seen with the first ICI treatment. They suggest that ICI-based regimens should be studied in prospective trials of patients who progressed on first-line immunotherapy.

Finally, Kim and colleagues reported outcomes of patients who developed anti-drug antibodies (ADA) against atezolizumab while on A/B. In this prospective cohort study, 174 patients with advanced HCC who were treated with first-line A/B were tested for serum ADA levels prior to treatment and at 3 weeks (cycle 2 day 1 [C2D1]). Clinically, patients with progressive disease exhibited higher ADA levels (median 65.2 [0-520.4] ng/mL) at C2D1 than responders (0-117.5 ng/mL). Patients with high ADA levels at C2D1 had a reduced response rate (29%-34% vs 7-11%) and worse PFS and OS. The investigators found that very high ADA levels (≥ 1000 ng/mL) at 3 weeks were consistently associated with poor clinical outcomes due to reduced systemic exposure to atezolizumab and impaired proliferation and activation of peripheral CD8-positive T cells. They suggested future validation and standardization of ADA assays to optimize treatment with atezolizumab in patients with uHCC.

Hatanaka and colleagues investigated whether the etiology of the underlying liver disease affected the efficacy of atezolizumab and bevacizumab (A/B). They reported the results of a retrospective cohort study of 323 patients with Barcelona Clinic Liver Cancer (BCLC) stage B or C hepatocellular carcinoma and Child-Pugh class A cirrhosis who started A/B between September 2020 and December 2021. Patients with viral infection were defined as those who were either serum anti–hepatitis C antibody (anti-HCV Ab)- or hepatitis B surface antigen (HBs-Ag)-positive, while patients with nonviral infection was defined as those who were both serum anti-HCV Ab- and HBs-Ag-negative. After propensity matching, no significant difference in response rate ([RR] 20.6% vs 24.6% in viral and nonviral patients), disease control rate (68.3% vs 69.0%), progression-free survival ([PFS] 7.0 months vs 6.2 months), or 12-month overall survival ([OS] 65.5% vs 71.7%) was seen. The authors concluded that the underlying etiology of liver disease in patients with HCC does not affect the response to treatment with A/B.

Scheiner and colleagues evaluated the efficacy of immunotherapy in patients with HCC who had already received immune checkpoint inhibitors (ICI) in a previous line of therapy. The authors reported the results of an international, retrospective multicenter study of 58 patients with HCC who received at least two lines of ICI-based therapies. The first ICI was discontinued due to disease progression in 90%. Nonetheless, the RR to the second ICI was 26% (compared with 22% for the first ICI), with a time-to-progression (TTP) of 5.4 months (95% CI, 3.0-7.7) for the first ICI and 5.2 months (95% CI, 3.3-7.0) for the second ICI. Grade 3/4 treatment-related adverse events were observed in 16% and 17% of patients with the first and second ICI, respectively. Therefore, the authors believe that ICI rechallenge is safe and results in a treatment benefit for a similar proportion of HCC patients, as is seen with the first ICI treatment. They suggest that ICI-based regimens should be studied in prospective trials of patients who progressed on first-line immunotherapy.

Finally, Kim and colleagues reported outcomes of patients who developed anti-drug antibodies (ADA) against atezolizumab while on A/B. In this prospective cohort study, 174 patients with advanced HCC who were treated with first-line A/B were tested for serum ADA levels prior to treatment and at 3 weeks (cycle 2 day 1 [C2D1]). Clinically, patients with progressive disease exhibited higher ADA levels (median 65.2 [0-520.4] ng/mL) at C2D1 than responders (0-117.5 ng/mL). Patients with high ADA levels at C2D1 had a reduced response rate (29%-34% vs 7-11%) and worse PFS and OS. The investigators found that very high ADA levels (≥ 1000 ng/mL) at 3 weeks were consistently associated with poor clinical outcomes due to reduced systemic exposure to atezolizumab and impaired proliferation and activation of peripheral CD8-positive T cells. They suggested future validation and standardization of ADA assays to optimize treatment with atezolizumab in patients with uHCC.

Hatanaka and colleagues investigated whether the etiology of the underlying liver disease affected the efficacy of atezolizumab and bevacizumab (A/B). They reported the results of a retrospective cohort study of 323 patients with Barcelona Clinic Liver Cancer (BCLC) stage B or C hepatocellular carcinoma and Child-Pugh class A cirrhosis who started A/B between September 2020 and December 2021. Patients with viral infection were defined as those who were either serum anti–hepatitis C antibody (anti-HCV Ab)- or hepatitis B surface antigen (HBs-Ag)-positive, while patients with nonviral infection was defined as those who were both serum anti-HCV Ab- and HBs-Ag-negative. After propensity matching, no significant difference in response rate ([RR] 20.6% vs 24.6% in viral and nonviral patients), disease control rate (68.3% vs 69.0%), progression-free survival ([PFS] 7.0 months vs 6.2 months), or 12-month overall survival ([OS] 65.5% vs 71.7%) was seen. The authors concluded that the underlying etiology of liver disease in patients with HCC does not affect the response to treatment with A/B.

Scheiner and colleagues evaluated the efficacy of immunotherapy in patients with HCC who had already received immune checkpoint inhibitors (ICI) in a previous line of therapy. The authors reported the results of an international, retrospective multicenter study of 58 patients with HCC who received at least two lines of ICI-based therapies. The first ICI was discontinued due to disease progression in 90%. Nonetheless, the RR to the second ICI was 26% (compared with 22% for the first ICI), with a time-to-progression (TTP) of 5.4 months (95% CI, 3.0-7.7) for the first ICI and 5.2 months (95% CI, 3.3-7.0) for the second ICI. Grade 3/4 treatment-related adverse events were observed in 16% and 17% of patients with the first and second ICI, respectively. Therefore, the authors believe that ICI rechallenge is safe and results in a treatment benefit for a similar proportion of HCC patients, as is seen with the first ICI treatment. They suggest that ICI-based regimens should be studied in prospective trials of patients who progressed on first-line immunotherapy.

Finally, Kim and colleagues reported outcomes of patients who developed anti-drug antibodies (ADA) against atezolizumab while on A/B. In this prospective cohort study, 174 patients with advanced HCC who were treated with first-line A/B were tested for serum ADA levels prior to treatment and at 3 weeks (cycle 2 day 1 [C2D1]). Clinically, patients with progressive disease exhibited higher ADA levels (median 65.2 [0-520.4] ng/mL) at C2D1 than responders (0-117.5 ng/mL). Patients with high ADA levels at C2D1 had a reduced response rate (29%-34% vs 7-11%) and worse PFS and OS. The investigators found that very high ADA levels (≥ 1000 ng/mL) at 3 weeks were consistently associated with poor clinical outcomes due to reduced systemic exposure to atezolizumab and impaired proliferation and activation of peripheral CD8-positive T cells. They suggested future validation and standardization of ADA assays to optimize treatment with atezolizumab in patients with uHCC.

Key clinical point: The use of aspirin is independently associated with a reduced risk for hepatocellular carcinoma (HCC) incidence, recurrence, and mortality, but an increased risk for bleeding.

Major finding: Aspirin use was associated with a reduced incidence of HCC (hazard ratio [HR] 0.75; 95% CI 0.71-0.80), recurrence of HCC (HR 0.79; 95% CI 0.65-0.96), and HCC-related mortality (HR 0.64; 95% CI 0.44-0.94), but an increased risk for bleeding (HR 1.10; 95% CI 1.02-1.20).

Study details: This study meta-analyzed the data of 3,273,524 individuals from 30 studies on HCC incidence, HCC recurrence, or mortality.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Ma S, Qu G et al. Does aspirin reduce the incidence, recurrence, and mortality of hepatocellular carcinoma? A GRADE-assessed systematic review and dose-response meta-analysis. Eur J Clin Pharmacol. 2022 (Nov 5). Doi: 10.1007/s00228-022-03414-y

Key clinical point: The use of aspirin is independently associated with a reduced risk for hepatocellular carcinoma (HCC) incidence, recurrence, and mortality, but an increased risk for bleeding.

Major finding: Aspirin use was associated with a reduced incidence of HCC (hazard ratio [HR] 0.75; 95% CI 0.71-0.80), recurrence of HCC (HR 0.79; 95% CI 0.65-0.96), and HCC-related mortality (HR 0.64; 95% CI 0.44-0.94), but an increased risk for bleeding (HR 1.10; 95% CI 1.02-1.20).

Study details: This study meta-analyzed the data of 3,273,524 individuals from 30 studies on HCC incidence, HCC recurrence, or mortality.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Ma S, Qu G et al. Does aspirin reduce the incidence, recurrence, and mortality of hepatocellular carcinoma? A GRADE-assessed systematic review and dose-response meta-analysis. Eur J Clin Pharmacol. 2022 (Nov 5). Doi: 10.1007/s00228-022-03414-y

Key clinical point: The use of aspirin is independently associated with a reduced risk for hepatocellular carcinoma (HCC) incidence, recurrence, and mortality, but an increased risk for bleeding.

Major finding: Aspirin use was associated with a reduced incidence of HCC (hazard ratio [HR] 0.75; 95% CI 0.71-0.80), recurrence of HCC (HR 0.79; 95% CI 0.65-0.96), and HCC-related mortality (HR 0.64; 95% CI 0.44-0.94), but an increased risk for bleeding (HR 1.10; 95% CI 1.02-1.20).

Study details: This study meta-analyzed the data of 3,273,524 individuals from 30 studies on HCC incidence, HCC recurrence, or mortality.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Ma S, Qu G et al. Does aspirin reduce the incidence, recurrence, and mortality of hepatocellular carcinoma? A GRADE-assessed systematic review and dose-response meta-analysis. Eur J Clin Pharmacol. 2022 (Nov 5). Doi: 10.1007/s00228-022-03414-y

Key clinical point: Among patients with hepatocellular carcinoma (HCC), an “ideal candidate for ablation” per the Barcelona Clinic Liver Cancer (BCLC) staging system may not be ideal for microwave ablation (MWA); however, patients with BCLC-0 disease may comprise the optimal population for MWA.

Major finding: Liver resection (LRE) vs MWA led to a significantly longer recurrence-free survival in the overall population (P = .025) and patients with BCLC-A disease (P = .003) but not in those with BCLC-0 disease (P = .270), in addition to similar overall survival (P = .976) and post-procedure-related complication rates (P = 1.00) in BCLC-0 patients.

Study details: This retrospective study included patients with HCC who met the criteria of “ideal candidates for ablation” per the BCLC staging system and propensity score-matched those receiving MWA and LRE (overall population 140 pairs; BCLC-0 disease 35 pairs; BCLC-A disease 99 pairs).

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

Source: Tong Y, Cai R  et al. Liver resection versus microwave ablation for hepatocellular carcinoma in ideal candidates for ablation per Barcelona Clinic Liver Cancer staging: A propensity score matching and inverse probability of treatment weighting analysis. Aliment Pharmacol Ther. 2022;56(11-12):1602-1614 (Oct 26). Doi: 10.1111/apt.17263

Key clinical point: Among patients with hepatocellular carcinoma (HCC), an “ideal candidate for ablation” per the Barcelona Clinic Liver Cancer (BCLC) staging system may not be ideal for microwave ablation (MWA); however, patients with BCLC-0 disease may comprise the optimal population for MWA.

Major finding: Liver resection (LRE) vs MWA led to a significantly longer recurrence-free survival in the overall population (P = .025) and patients with BCLC-A disease (P = .003) but not in those with BCLC-0 disease (P = .270), in addition to similar overall survival (P = .976) and post-procedure-related complication rates (P = 1.00) in BCLC-0 patients.

Study details: This retrospective study included patients with HCC who met the criteria of “ideal candidates for ablation” per the BCLC staging system and propensity score-matched those receiving MWA and LRE (overall population 140 pairs; BCLC-0 disease 35 pairs; BCLC-A disease 99 pairs).

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

Source: Tong Y, Cai R  et al. Liver resection versus microwave ablation for hepatocellular carcinoma in ideal candidates for ablation per Barcelona Clinic Liver Cancer staging: A propensity score matching and inverse probability of treatment weighting analysis. Aliment Pharmacol Ther. 2022;56(11-12):1602-1614 (Oct 26). Doi: 10.1111/apt.17263

Key clinical point: Among patients with hepatocellular carcinoma (HCC), an “ideal candidate for ablation” per the Barcelona Clinic Liver Cancer (BCLC) staging system may not be ideal for microwave ablation (MWA); however, patients with BCLC-0 disease may comprise the optimal population for MWA.

Major finding: Liver resection (LRE) vs MWA led to a significantly longer recurrence-free survival in the overall population (P = .025) and patients with BCLC-A disease (P = .003) but not in those with BCLC-0 disease (P = .270), in addition to similar overall survival (P = .976) and post-procedure-related complication rates (P = 1.00) in BCLC-0 patients.

Study details: This retrospective study included patients with HCC who met the criteria of “ideal candidates for ablation” per the BCLC staging system and propensity score-matched those receiving MWA and LRE (overall population 140 pairs; BCLC-0 disease 35 pairs; BCLC-A disease 99 pairs).

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

Source: Tong Y, Cai R  et al. Liver resection versus microwave ablation for hepatocellular carcinoma in ideal candidates for ablation per Barcelona Clinic Liver Cancer staging: A propensity score matching and inverse probability of treatment weighting analysis. Aliment Pharmacol Ther. 2022;56(11-12):1602-1614 (Oct 26). Doi: 10.1111/apt.17263

Key clinical point: Compared with transcatheter arterial chemoembolization (TACE) followed by radiotherapy (RT), administering RT before TACE leads to better survival outcomes in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT).

Major finding: Patients who received RT+TACE vs TACE+RT had significantly longer median progression-free survival (6.6 vs 4.2 months; hazard ratio [HR] 0.66; P = .030), with the prolongation of median overall survival being marginally significant (15.4 vs 11.5 months; HR 0.68; P = .054).

Study details: Findings are from a randomized controlled study including 120 patients with unresectable HCC and PVTT who were randomly assigned (1:1) to receive RT+TACE or TACE+RT.

Disclosures: This study was supported by the Clinical Research Plan of Shanghai Shenkang Hospital Development Center, China, among others. The authors declared no conflicts of interest.

Source: Guo L et al. Radiotherapy prior to or after transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with portal vein tumor thrombus: A randomized controlled trial. Hepatol Int. 2022 (Oct 21). Doi: 10.1007/s12072-022-10423-7

Key clinical point: Compared with transcatheter arterial chemoembolization (TACE) followed by radiotherapy (RT), administering RT before TACE leads to better survival outcomes in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT).

Major finding: Patients who received RT+TACE vs TACE+RT had significantly longer median progression-free survival (6.6 vs 4.2 months; hazard ratio [HR] 0.66; P = .030), with the prolongation of median overall survival being marginally significant (15.4 vs 11.5 months; HR 0.68; P = .054).

Study details: Findings are from a randomized controlled study including 120 patients with unresectable HCC and PVTT who were randomly assigned (1:1) to receive RT+TACE or TACE+RT.

Disclosures: This study was supported by the Clinical Research Plan of Shanghai Shenkang Hospital Development Center, China, among others. The authors declared no conflicts of interest.

Source: Guo L et al. Radiotherapy prior to or after transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with portal vein tumor thrombus: A randomized controlled trial. Hepatol Int. 2022 (Oct 21). Doi: 10.1007/s12072-022-10423-7

Key clinical point: Compared with transcatheter arterial chemoembolization (TACE) followed by radiotherapy (RT), administering RT before TACE leads to better survival outcomes in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT).

Major finding: Patients who received RT+TACE vs TACE+RT had significantly longer median progression-free survival (6.6 vs 4.2 months; hazard ratio [HR] 0.66; P = .030), with the prolongation of median overall survival being marginally significant (15.4 vs 11.5 months; HR 0.68; P = .054).

Study details: Findings are from a randomized controlled study including 120 patients with unresectable HCC and PVTT who were randomly assigned (1:1) to receive RT+TACE or TACE+RT.

Disclosures: This study was supported by the Clinical Research Plan of Shanghai Shenkang Hospital Development Center, China, among others. The authors declared no conflicts of interest.

Source: Guo L et al. Radiotherapy prior to or after transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with portal vein tumor thrombus: A randomized controlled trial. Hepatol Int. 2022 (Oct 21). Doi: 10.1007/s12072-022-10423-7

Key clinical point: Atezolizumab plus bevacizumab (Atezo/Bev) is a more effective and safe first-line therapy than lenvatinib in patients with unresectable hepatocellular carcinoma (HCC).

Major finding: Patients who received Atezo/Bev vs lenvatinib had a significantly longer progression-free survival (8.3 vs 6.0 months; P = .005) and overall survival (median survival time not reached vs 20.2 months; P = .039) and lower prevalence of grade ≥3 adverse events, such as hypertension (P = .004) and proteinuria (P = .046).

Study details: This retrospective study propensity score-matched patients with unresectable HCC who received Atezo/Bev (n = 152) with those who received lenvatinib (n = 152) as first-line systemic therapies.

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

Source: Niizeki T et al. Comparison of efficacy and safety of atezolizumab plus bevacizumab and lenvatinib as first-line therapy for unresectable hepatocellular carcinoma: A propensity score matching analysis. Target Oncol. 2022 (Oct 22). Doi: 10.1007/s11523-022-00921-x

Key clinical point: Atezolizumab plus bevacizumab (Atezo/Bev) is a more effective and safe first-line therapy than lenvatinib in patients with unresectable hepatocellular carcinoma (HCC).

Major finding: Patients who received Atezo/Bev vs lenvatinib had a significantly longer progression-free survival (8.3 vs 6.0 months; P = .005) and overall survival (median survival time not reached vs 20.2 months; P = .039) and lower prevalence of grade ≥3 adverse events, such as hypertension (P = .004) and proteinuria (P = .046).

Study details: This retrospective study propensity score-matched patients with unresectable HCC who received Atezo/Bev (n = 152) with those who received lenvatinib (n = 152) as first-line systemic therapies.

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

Source: Niizeki T et al. Comparison of efficacy and safety of atezolizumab plus bevacizumab and lenvatinib as first-line therapy for unresectable hepatocellular carcinoma: A propensity score matching analysis. Target Oncol. 2022 (Oct 22). Doi: 10.1007/s11523-022-00921-x

Key clinical point: Atezolizumab plus bevacizumab (Atezo/Bev) is a more effective and safe first-line therapy than lenvatinib in patients with unresectable hepatocellular carcinoma (HCC).

Major finding: Patients who received Atezo/Bev vs lenvatinib had a significantly longer progression-free survival (8.3 vs 6.0 months; P = .005) and overall survival (median survival time not reached vs 20.2 months; P = .039) and lower prevalence of grade ≥3 adverse events, such as hypertension (P = .004) and proteinuria (P = .046).

Study details: This retrospective study propensity score-matched patients with unresectable HCC who received Atezo/Bev (n = 152) with those who received lenvatinib (n = 152) as first-line systemic therapies.

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

Source: Niizeki T et al. Comparison of efficacy and safety of atezolizumab plus bevacizumab and lenvatinib as first-line therapy for unresectable hepatocellular carcinoma: A propensity score matching analysis. Target Oncol. 2022 (Oct 22). Doi: 10.1007/s11523-022-00921-x

Key clinical point: The combination of alpha-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) may effectively predict the prognosis of patients with hepatocellular carcinoma (HCC) after radical hepatectomy.

Major finding: The 5-year overall and recurrence-free survival rates were significantly lower among patients with high preoperative serum AFP and CA19-9 levels than among those with high serum AFP or CA19-9 levels (P = .022 and P = .004, respectively) and those with low serum AFP and CA19-9 levels (both P < .001).

Study details: This retrospective study included 711 patients with HCC who were categorized as having low (≤400 ng/mL; n = 381) or high (>400 ng/mL; n = 330) preoperative serum AFP levels and as having low (≤37 U/mL; n = 552) or high (>37 U/mL; n = 159) preoperative serum CA19-9 levels.

Disclosures: This study was sponsored by the Youth Program of Scientific Research Foundation of Guangxi Medical University Cancer Hospital, China, among others. The authors declared no conflicts of interest.

Source: Zhang J et al. Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomy. World J Surg Oncol. 2022;20:346 (Oct 19). Doi: 10.1186/s12957-022-02806-9

Key clinical point: The combination of alpha-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) may effectively predict the prognosis of patients with hepatocellular carcinoma (HCC) after radical hepatectomy.

Major finding: The 5-year overall and recurrence-free survival rates were significantly lower among patients with high preoperative serum AFP and CA19-9 levels than among those with high serum AFP or CA19-9 levels (P = .022 and P = .004, respectively) and those with low serum AFP and CA19-9 levels (both P < .001).

Study details: This retrospective study included 711 patients with HCC who were categorized as having low (≤400 ng/mL; n = 381) or high (>400 ng/mL; n = 330) preoperative serum AFP levels and as having low (≤37 U/mL; n = 552) or high (>37 U/mL; n = 159) preoperative serum CA19-9 levels.

Disclosures: This study was sponsored by the Youth Program of Scientific Research Foundation of Guangxi Medical University Cancer Hospital, China, among others. The authors declared no conflicts of interest.

Source: Zhang J et al. Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomy. World J Surg Oncol. 2022;20:346 (Oct 19). Doi: 10.1186/s12957-022-02806-9

Key clinical point: The combination of alpha-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) may effectively predict the prognosis of patients with hepatocellular carcinoma (HCC) after radical hepatectomy.

Major finding: The 5-year overall and recurrence-free survival rates were significantly lower among patients with high preoperative serum AFP and CA19-9 levels than among those with high serum AFP or CA19-9 levels (P = .022 and P = .004, respectively) and those with low serum AFP and CA19-9 levels (both P < .001).

Study details: This retrospective study included 711 patients with HCC who were categorized as having low (≤400 ng/mL; n = 381) or high (>400 ng/mL; n = 330) preoperative serum AFP levels and as having low (≤37 U/mL; n = 552) or high (>37 U/mL; n = 159) preoperative serum CA19-9 levels.

Disclosures: This study was sponsored by the Youth Program of Scientific Research Foundation of Guangxi Medical University Cancer Hospital, China, among others. The authors declared no conflicts of interest.

Source: Zhang J et al. Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomy. World J Surg Oncol. 2022;20:346 (Oct 19). Doi: 10.1186/s12957-022-02806-9

Key clinical point: Compared with hepatic arterial infusion chemotherapy (HAIC)+lenvatinib, the triple therapeutic regimen HAIC+lenvatinib+sequential ablation significantly improved the survival of patients with advanced hepatocellular carcinoma (HCC) without compromising safety.

Major finding: Patients who received HAIC+lenvatinib+sequential ablation vs HAIC+lenvatinib had a significantly longer median overall survival (>30 vs 13.6 months; P = .010), progression-free survival (PFS; 12.8 vs 5.6 months; P = .001), and intrahepatic PFS (14.6 vs 6.4 months; P = .002) and similar incidence of grade 1-2 (P = .404) and 3-4 (P = .333) adverse events.

Study details: This multicenter retrospective study included 150 patients with advanced HCC who received HAIC+lenvatinib (n = 97) or HAIC+lenvatinib+sequential ablation (n = 53).

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

Source: Liu Y et al. Efficacy and safety of hepatic arterial infusion chemotherapy combined with lenvatinib and sequential ablation in the treatment of advanced hepatocellular carcinoma. Cancer Med. 2022 (Oct 17). Doi: 10.1002/cam4.5366

Key clinical point: Compared with hepatic arterial infusion chemotherapy (HAIC)+lenvatinib, the triple therapeutic regimen HAIC+lenvatinib+sequential ablation significantly improved the survival of patients with advanced hepatocellular carcinoma (HCC) without compromising safety.

Major finding: Patients who received HAIC+lenvatinib+sequential ablation vs HAIC+lenvatinib had a significantly longer median overall survival (>30 vs 13.6 months; P = .010), progression-free survival (PFS; 12.8 vs 5.6 months; P = .001), and intrahepatic PFS (14.6 vs 6.4 months; P = .002) and similar incidence of grade 1-2 (P = .404) and 3-4 (P = .333) adverse events.

Study details: This multicenter retrospective study included 150 patients with advanced HCC who received HAIC+lenvatinib (n = 97) or HAIC+lenvatinib+sequential ablation (n = 53).

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

Source: Liu Y et al. Efficacy and safety of hepatic arterial infusion chemotherapy combined with lenvatinib and sequential ablation in the treatment of advanced hepatocellular carcinoma. Cancer Med. 2022 (Oct 17). Doi: 10.1002/cam4.5366

Key clinical point: Compared with hepatic arterial infusion chemotherapy (HAIC)+lenvatinib, the triple therapeutic regimen HAIC+lenvatinib+sequential ablation significantly improved the survival of patients with advanced hepatocellular carcinoma (HCC) without compromising safety.

Major finding: Patients who received HAIC+lenvatinib+sequential ablation vs HAIC+lenvatinib had a significantly longer median overall survival (>30 vs 13.6 months; P = .010), progression-free survival (PFS; 12.8 vs 5.6 months; P = .001), and intrahepatic PFS (14.6 vs 6.4 months; P = .002) and similar incidence of grade 1-2 (P = .404) and 3-4 (P = .333) adverse events.

Study details: This multicenter retrospective study included 150 patients with advanced HCC who received HAIC+lenvatinib (n = 97) or HAIC+lenvatinib+sequential ablation (n = 53).

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

Source: Liu Y et al. Efficacy and safety of hepatic arterial infusion chemotherapy combined with lenvatinib and sequential ablation in the treatment of advanced hepatocellular carcinoma. Cancer Med. 2022 (Oct 17). Doi: 10.1002/cam4.5366

Key clinical point: Atezolizumab plus bevacizumab (Atez/Bev) is effective and safe against both virus-related and non-viral hepatocellular carcinoma (HCC).

Major finding: The objective response rate (20.6% and 24.6%, respectively; P = .55), median progression-free survival (7.0 and 6.2 months, respectively; hazard ratio 0.96; P = .33), and incidence and severity of adverse events, including diarrhea and liver injury, were comparable between patients with virus-related and non-viral HCC.

Study details: Findings are from a retrospective cohort study including 126 propensity score-matched pairs of patients with virus-related and non-viral HCC who had Child-Pugh class A, Barcelona Clinic Liver Cancer stage B or C, and performance status ≤1 and received Atez/Bev.

Disclosures: No source of funding was reported. Some authors declared receiving honoraria and research grants from various sources.

Source: Hatanaka T et al. Comparative efficacy and safety of atezolizumab and bevacizumab between hepatocellular carcinoma patients with viral and non-viral infection: A Japanese multicenter observational study. Cancer Med. 2022 (Oct 13). Doi: 10.1002/cam4.5337

Key clinical point: Atezolizumab plus bevacizumab (Atez/Bev) is effective and safe against both virus-related and non-viral hepatocellular carcinoma (HCC).

Major finding: The objective response rate (20.6% and 24.6%, respectively; P = .55), median progression-free survival (7.0 and 6.2 months, respectively; hazard ratio 0.96; P = .33), and incidence and severity of adverse events, including diarrhea and liver injury, were comparable between patients with virus-related and non-viral HCC.

Study details: Findings are from a retrospective cohort study including 126 propensity score-matched pairs of patients with virus-related and non-viral HCC who had Child-Pugh class A, Barcelona Clinic Liver Cancer stage B or C, and performance status ≤1 and received Atez/Bev.

Disclosures: No source of funding was reported. Some authors declared receiving honoraria and research grants from various sources.

Source: Hatanaka T et al. Comparative efficacy and safety of atezolizumab and bevacizumab between hepatocellular carcinoma patients with viral and non-viral infection: A Japanese multicenter observational study. Cancer Med. 2022 (Oct 13). Doi: 10.1002/cam4.5337

Key clinical point: Atezolizumab plus bevacizumab (Atez/Bev) is effective and safe against both virus-related and non-viral hepatocellular carcinoma (HCC).

Major finding: The objective response rate (20.6% and 24.6%, respectively; P = .55), median progression-free survival (7.0 and 6.2 months, respectively; hazard ratio 0.96; P = .33), and incidence and severity of adverse events, including diarrhea and liver injury, were comparable between patients with virus-related and non-viral HCC.

Study details: Findings are from a retrospective cohort study including 126 propensity score-matched pairs of patients with virus-related and non-viral HCC who had Child-Pugh class A, Barcelona Clinic Liver Cancer stage B or C, and performance status ≤1 and received Atez/Bev.

Disclosures: No source of funding was reported. Some authors declared receiving honoraria and research grants from various sources.

Source: Hatanaka T et al. Comparative efficacy and safety of atezolizumab and bevacizumab between hepatocellular carcinoma patients with viral and non-viral infection: A Japanese multicenter observational study. Cancer Med. 2022 (Oct 13). Doi: 10.1002/cam4.5337

Key clinical point: The use of immune checkpoint inhibitor (ICI)-based regimens after prior immunotherapy is safe and confers a treatment benefit in a clinically meaningful proportion of patients with hepatocellular carcinoma (HCC).

Major finding: The objective response and disease control rates were 22% and 59% with first-line ICI therapy (ICI-1) and 26% and 55% with second-line ICI therapy (ICI-2), respectively. The median times to progression with ICI-1 and ICI-2 were 5.4 (95% CI 3.0-7.7) months and 5.2 (95% CI 3.3-7.0) months, respectively. Grade 3-4 treatment-related adverse events with ICI-1 and ICI-2 occurred in 16% and 17% of patients, respectively.

Study details: This multicenter retrospective included 58 patients with HCC who received ≥2 lines of ICI-based therapies.

Disclosures: This study did not receive any specific funding. Some authors declared serving as investigators for or receiving advisory, consulting, or speaker fees or travel support from various sources.

Source: Scheiner B et al. Efficacy and safety of immune checkpoint inhibitor rechallenge in individuals with hepatocellular carcinoma. JHEP Rep. 2022;100620 (Oct 26). Doi: 10.1016/j.jhepr.2022.100620

Key clinical point: The use of immune checkpoint inhibitor (ICI)-based regimens after prior immunotherapy is safe and confers a treatment benefit in a clinically meaningful proportion of patients with hepatocellular carcinoma (HCC).

Major finding: The objective response and disease control rates were 22% and 59% with first-line ICI therapy (ICI-1) and 26% and 55% with second-line ICI therapy (ICI-2), respectively. The median times to progression with ICI-1 and ICI-2 were 5.4 (95% CI 3.0-7.7) months and 5.2 (95% CI 3.3-7.0) months, respectively. Grade 3-4 treatment-related adverse events with ICI-1 and ICI-2 occurred in 16% and 17% of patients, respectively.

Study details: This multicenter retrospective included 58 patients with HCC who received ≥2 lines of ICI-based therapies.

Disclosures: This study did not receive any specific funding. Some authors declared serving as investigators for or receiving advisory, consulting, or speaker fees or travel support from various sources.

Source: Scheiner B et al. Efficacy and safety of immune checkpoint inhibitor rechallenge in individuals with hepatocellular carcinoma. JHEP Rep. 2022;100620 (Oct 26). Doi: 10.1016/j.jhepr.2022.100620

Key clinical point: The use of immune checkpoint inhibitor (ICI)-based regimens after prior immunotherapy is safe and confers a treatment benefit in a clinically meaningful proportion of patients with hepatocellular carcinoma (HCC).

Major finding: The objective response and disease control rates were 22% and 59% with first-line ICI therapy (ICI-1) and 26% and 55% with second-line ICI therapy (ICI-2), respectively. The median times to progression with ICI-1 and ICI-2 were 5.4 (95% CI 3.0-7.7) months and 5.2 (95% CI 3.3-7.0) months, respectively. Grade 3-4 treatment-related adverse events with ICI-1 and ICI-2 occurred in 16% and 17% of patients, respectively.

Study details: This multicenter retrospective included 58 patients with HCC who received ≥2 lines of ICI-based therapies.

Disclosures: This study did not receive any specific funding. Some authors declared serving as investigators for or receiving advisory, consulting, or speaker fees or travel support from various sources.

Source: Scheiner B et al. Efficacy and safety of immune checkpoint inhibitor rechallenge in individuals with hepatocellular carcinoma. JHEP Rep. 2022;100620 (Oct 26). Doi: 10.1016/j.jhepr.2022.100620

Key clinical point: Compared with sorafenib, atezolizumab-bevacizumab led to more frequent acute variceal bleeding (AVB) in patients with locally advanced hepatocellular carcinoma (HCC) and cirrhosis, with a history of AVB being associated with AVB during follow-up.

Major finding: At 1 year, patients who received atezolizumab-bevacizumab vs sorafenib had significantly higher AVB occurrence (21% vs 5%; P = .02). A previous history of AVB was independently associated with AVB during therapy (adjusted hazard ratio 10.58; P = .03).

Study details: This single-center prospective study included 43 patients with locally advanced HCC and cirrhosis who received atezolizumab-bevacizumab and a retrospective series of 122 control patients who received sorafenib.

Disclosures: This study did not receive any funding. No information on conflicts of interest was provided.

Source: Larrey E et al. A history of variceal bleeding is associated with further bleeding under atezolizumab-bevacizumab in patients with HCC. Liver Int. 2022 (Oct 18). Doi: 10.1111/liv.15458

Key clinical point: Compared with sorafenib, atezolizumab-bevacizumab led to more frequent acute variceal bleeding (AVB) in patients with locally advanced hepatocellular carcinoma (HCC) and cirrhosis, with a history of AVB being associated with AVB during follow-up.

Major finding: At 1 year, patients who received atezolizumab-bevacizumab vs sorafenib had significantly higher AVB occurrence (21% vs 5%; P = .02). A previous history of AVB was independently associated with AVB during therapy (adjusted hazard ratio 10.58; P = .03).

Study details: This single-center prospective study included 43 patients with locally advanced HCC and cirrhosis who received atezolizumab-bevacizumab and a retrospective series of 122 control patients who received sorafenib.

Disclosures: This study did not receive any funding. No information on conflicts of interest was provided.

Source: Larrey E et al. A history of variceal bleeding is associated with further bleeding under atezolizumab-bevacizumab in patients with HCC. Liver Int. 2022 (Oct 18). Doi: 10.1111/liv.15458

Key clinical point: Compared with sorafenib, atezolizumab-bevacizumab led to more frequent acute variceal bleeding (AVB) in patients with locally advanced hepatocellular carcinoma (HCC) and cirrhosis, with a history of AVB being associated with AVB during follow-up.

Major finding: At 1 year, patients who received atezolizumab-bevacizumab vs sorafenib had significantly higher AVB occurrence (21% vs 5%; P = .02). A previous history of AVB was independently associated with AVB during therapy (adjusted hazard ratio 10.58; P = .03).

Study details: This single-center prospective study included 43 patients with locally advanced HCC and cirrhosis who received atezolizumab-bevacizumab and a retrospective series of 122 control patients who received sorafenib.

Disclosures: This study did not receive any funding. No information on conflicts of interest was provided.

Source: Larrey E et al. A history of variceal bleeding is associated with further bleeding under atezolizumab-bevacizumab in patients with HCC. Liver Int. 2022 (Oct 18). Doi: 10.1111/liv.15458