Hepatocellular Carcinoma

Tyrosine kinase inhibitors are the mainstay of systemic HCC therapy, however treatment at FDA-approved doses frequently leads to unacceptable toxicities, leading to reductions in the prescribed dose. Tokunaga et al. investigated whether lenvatinib dose intensity affects outcomes of patients with unresectable HCC. This was a retrospective analysis of 100 patients who received lenvatinib in the first- or later-line settings. Fifty-one patients started lenvatinib at the standard dose and 49 patients at a reduced dose. Dose reduction was carried out in 29 patients during cycle 1, and 62 patients during all cycles, with the cumulative dose reduction rate in all cycles of 79.9%.  Upon analysis, the authors confirmed that tumor responses and stable disease on lenvatinib correlated favorably with overall survival (OS) and time to progression (TTP). In addition, they found that higher dose intensity correlated with a higher response rate, though most (56%) patients were unable to maintain the recommended dose intensity due to unacceptable adverse events. In the final analysis, dose modification was not negatively associated with OS, TTP, or disease control with lenvatinib. Therefore, it remains reasonable to adjust the dose of lenvatinib to minimize toxicity that would affect adversely patient quality of life. Disease control remains the best predictor of longer survival, though it does not seem that highest doses of lenvatinib are needed to achieve that benefit.

Cabozantinib is approved for previously treated patients with unresectable HCC based on the phase III CELESTIAL trial that enrolled patients with Child Pugh A liver disease who had received up to two previous systemic treatments, one of which was sorafenib. This study demonstrated a statistically significant improvement in overall- and disease-free survival. Kelley et al analyzed the outcomes based on the albumin-bilirubin (ALBI) grade, an objective measure of liver function, of patients in the CELESTIAL trial. ALBI scores were retrospectively calculated based on baseline serum albumin and total bilirubin. The median OS was 17.5 months in the cabozantinib arm versus 11.4 months in the placebo arm for the ALBI grade 1 subgroup, and 8.0 months in the cabozantinib arm versus 6.4 months in the placebo arm for the ALBI grade 2 subgroup. The authors concluded that cabozantinib benefits patients with unresectable HCC irrespective of their ALBI grade, though liver dysfunction remains a poor prognostic indicator in patients with HCC.

Finally, Liu et al analyzed 27 patients with HCC (8 with extrahepatic spread) who received a combination of chemotherapy via hepatic artery infusion, anti-PD-1 immunotherapy, and tyrosine kinase inhibitor. Combination chemotherapy and immunotherapy resulted in a median progression-free survival of 10.6 months with a median 12.9 months’ follow up; the objective response rate was 63.0% and the disease control rate was 92.6%. The authors concluded that this combination of therapies was effective and well-tolerated, with a confirmatory phase 3 study planned.

Tyrosine kinase inhibitors are the mainstay of systemic HCC therapy, however treatment at FDA-approved doses frequently leads to unacceptable toxicities, leading to reductions in the prescribed dose. Tokunaga et al. investigated whether lenvatinib dose intensity affects outcomes of patients with unresectable HCC. This was a retrospective analysis of 100 patients who received lenvatinib in the first- or later-line settings. Fifty-one patients started lenvatinib at the standard dose and 49 patients at a reduced dose. Dose reduction was carried out in 29 patients during cycle 1, and 62 patients during all cycles, with the cumulative dose reduction rate in all cycles of 79.9%.  Upon analysis, the authors confirmed that tumor responses and stable disease on lenvatinib correlated favorably with overall survival (OS) and time to progression (TTP). In addition, they found that higher dose intensity correlated with a higher response rate, though most (56%) patients were unable to maintain the recommended dose intensity due to unacceptable adverse events. In the final analysis, dose modification was not negatively associated with OS, TTP, or disease control with lenvatinib. Therefore, it remains reasonable to adjust the dose of lenvatinib to minimize toxicity that would affect adversely patient quality of life. Disease control remains the best predictor of longer survival, though it does not seem that highest doses of lenvatinib are needed to achieve that benefit.

Cabozantinib is approved for previously treated patients with unresectable HCC based on the phase III CELESTIAL trial that enrolled patients with Child Pugh A liver disease who had received up to two previous systemic treatments, one of which was sorafenib. This study demonstrated a statistically significant improvement in overall- and disease-free survival. Kelley et al analyzed the outcomes based on the albumin-bilirubin (ALBI) grade, an objective measure of liver function, of patients in the CELESTIAL trial. ALBI scores were retrospectively calculated based on baseline serum albumin and total bilirubin. The median OS was 17.5 months in the cabozantinib arm versus 11.4 months in the placebo arm for the ALBI grade 1 subgroup, and 8.0 months in the cabozantinib arm versus 6.4 months in the placebo arm for the ALBI grade 2 subgroup. The authors concluded that cabozantinib benefits patients with unresectable HCC irrespective of their ALBI grade, though liver dysfunction remains a poor prognostic indicator in patients with HCC.

Finally, Liu et al analyzed 27 patients with HCC (8 with extrahepatic spread) who received a combination of chemotherapy via hepatic artery infusion, anti-PD-1 immunotherapy, and tyrosine kinase inhibitor. Combination chemotherapy and immunotherapy resulted in a median progression-free survival of 10.6 months with a median 12.9 months’ follow up; the objective response rate was 63.0% and the disease control rate was 92.6%. The authors concluded that this combination of therapies was effective and well-tolerated, with a confirmatory phase 3 study planned.

Tyrosine kinase inhibitors are the mainstay of systemic HCC therapy, however treatment at FDA-approved doses frequently leads to unacceptable toxicities, leading to reductions in the prescribed dose. Tokunaga et al. investigated whether lenvatinib dose intensity affects outcomes of patients with unresectable HCC. This was a retrospective analysis of 100 patients who received lenvatinib in the first- or later-line settings. Fifty-one patients started lenvatinib at the standard dose and 49 patients at a reduced dose. Dose reduction was carried out in 29 patients during cycle 1, and 62 patients during all cycles, with the cumulative dose reduction rate in all cycles of 79.9%.  Upon analysis, the authors confirmed that tumor responses and stable disease on lenvatinib correlated favorably with overall survival (OS) and time to progression (TTP). In addition, they found that higher dose intensity correlated with a higher response rate, though most (56%) patients were unable to maintain the recommended dose intensity due to unacceptable adverse events. In the final analysis, dose modification was not negatively associated with OS, TTP, or disease control with lenvatinib. Therefore, it remains reasonable to adjust the dose of lenvatinib to minimize toxicity that would affect adversely patient quality of life. Disease control remains the best predictor of longer survival, though it does not seem that highest doses of lenvatinib are needed to achieve that benefit.

Cabozantinib is approved for previously treated patients with unresectable HCC based on the phase III CELESTIAL trial that enrolled patients with Child Pugh A liver disease who had received up to two previous systemic treatments, one of which was sorafenib. This study demonstrated a statistically significant improvement in overall- and disease-free survival. Kelley et al analyzed the outcomes based on the albumin-bilirubin (ALBI) grade, an objective measure of liver function, of patients in the CELESTIAL trial. ALBI scores were retrospectively calculated based on baseline serum albumin and total bilirubin. The median OS was 17.5 months in the cabozantinib arm versus 11.4 months in the placebo arm for the ALBI grade 1 subgroup, and 8.0 months in the cabozantinib arm versus 6.4 months in the placebo arm for the ALBI grade 2 subgroup. The authors concluded that cabozantinib benefits patients with unresectable HCC irrespective of their ALBI grade, though liver dysfunction remains a poor prognostic indicator in patients with HCC.

Finally, Liu et al analyzed 27 patients with HCC (8 with extrahepatic spread) who received a combination of chemotherapy via hepatic artery infusion, anti-PD-1 immunotherapy, and tyrosine kinase inhibitor. Combination chemotherapy and immunotherapy resulted in a median progression-free survival of 10.6 months with a median 12.9 months’ follow up; the objective response rate was 63.0% and the disease control rate was 92.6%. The authors concluded that this combination of therapies was effective and well-tolerated, with a confirmatory phase 3 study planned.

Key clinical point: The primary outcome of local recurrence-free survival was significantly longer for lesions showing complete retention than for those showing incomplete retention, but overall survival was no different based on lipidiol retention.  

Major finding: After propensity score matching of 121 pairs of lesions with complete/incomplete retention, the median local recurrence-free survival for lesions exhibiting complete retention was 1,279 days, compared to a median of 819 days in the incomplete retention group (P = 0.030).

Study details: The data come from 198 adult patients with a total of 280 HCC lesions who underwent transarterial lipiodol injection and thermal ablation at three centers between June 2014 and September 2020.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Tan J et al. Abdom Radiol. 2021 Oct 12. doi: 10.1007/s00261-021-03305-3.

Key clinical point: The primary outcome of local recurrence-free survival was significantly longer for lesions showing complete retention than for those showing incomplete retention, but overall survival was no different based on lipidiol retention.  

Major finding: After propensity score matching of 121 pairs of lesions with complete/incomplete retention, the median local recurrence-free survival for lesions exhibiting complete retention was 1,279 days, compared to a median of 819 days in the incomplete retention group (P = 0.030).

Study details: The data come from 198 adult patients with a total of 280 HCC lesions who underwent transarterial lipiodol injection and thermal ablation at three centers between June 2014 and September 2020.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Tan J et al. Abdom Radiol. 2021 Oct 12. doi: 10.1007/s00261-021-03305-3.

Key clinical point: The primary outcome of local recurrence-free survival was significantly longer for lesions showing complete retention than for those showing incomplete retention, but overall survival was no different based on lipidiol retention.  

Major finding: After propensity score matching of 121 pairs of lesions with complete/incomplete retention, the median local recurrence-free survival for lesions exhibiting complete retention was 1,279 days, compared to a median of 819 days in the incomplete retention group (P = 0.030).

Study details: The data come from 198 adult patients with a total of 280 HCC lesions who underwent transarterial lipiodol injection and thermal ablation at three centers between June 2014 and September 2020.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Tan J et al. Abdom Radiol. 2021 Oct 12. doi: 10.1007/s00261-021-03305-3.

Key clinical point: Time to progression and progression-free survival significantly improved among adults with HCC who received a combination of trans-arterial chemoembolization (TACE) and sorafenib compared to those who received TACE alone or with placebo; both objective response rate and disease control rate also improved in combination therapy patients.

Major finding: The combination therapy of trans-arterial chemoembolization (TACE) and sorafenib significantly improved time to progression (hazard ratio 0.73; P = 0.03) and progression-free survival (HR 0.62; P < 0.00001) compared to TACE alone or with placebo; however, the combination did not improve overall survival compared to the other groups.

Study details: The data come from a meta-analysis of 7 randomized, controlled trials with a total of 1,464 patients; of these, 734 had TACE plus sorafenib and 730 had TACE plus placebo or TACE only.

Disclosures: The study was supported by the National Key Research and Development Program of China and the National Natural Science Foundation of China. The researchers had no financial conflicts to disclose.

Source: Dai Y et al. Transl Oncol. 2021 Oct 7. doi: 10.1016/j.tranon.2021.101238. 

Key clinical point: Time to progression and progression-free survival significantly improved among adults with HCC who received a combination of trans-arterial chemoembolization (TACE) and sorafenib compared to those who received TACE alone or with placebo; both objective response rate and disease control rate also improved in combination therapy patients.

Major finding: The combination therapy of trans-arterial chemoembolization (TACE) and sorafenib significantly improved time to progression (hazard ratio 0.73; P = 0.03) and progression-free survival (HR 0.62; P < 0.00001) compared to TACE alone or with placebo; however, the combination did not improve overall survival compared to the other groups.

Study details: The data come from a meta-analysis of 7 randomized, controlled trials with a total of 1,464 patients; of these, 734 had TACE plus sorafenib and 730 had TACE plus placebo or TACE only.

Disclosures: The study was supported by the National Key Research and Development Program of China and the National Natural Science Foundation of China. The researchers had no financial conflicts to disclose.

Source: Dai Y et al. Transl Oncol. 2021 Oct 7. doi: 10.1016/j.tranon.2021.101238. 

Key clinical point: Time to progression and progression-free survival significantly improved among adults with HCC who received a combination of trans-arterial chemoembolization (TACE) and sorafenib compared to those who received TACE alone or with placebo; both objective response rate and disease control rate also improved in combination therapy patients.

Major finding: The combination therapy of trans-arterial chemoembolization (TACE) and sorafenib significantly improved time to progression (hazard ratio 0.73; P = 0.03) and progression-free survival (HR 0.62; P < 0.00001) compared to TACE alone or with placebo; however, the combination did not improve overall survival compared to the other groups.

Study details: The data come from a meta-analysis of 7 randomized, controlled trials with a total of 1,464 patients; of these, 734 had TACE plus sorafenib and 730 had TACE plus placebo or TACE only.

Disclosures: The study was supported by the National Key Research and Development Program of China and the National Natural Science Foundation of China. The researchers had no financial conflicts to disclose.

Source: Dai Y et al. Transl Oncol. 2021 Oct 7. doi: 10.1016/j.tranon.2021.101238. 

Key clinical point: Nucleotide analog therapy (NtA) significantly reduced risk of HCC recurrence and increased overall survival compared to nucleoside analog therapy (NsA) in patients who underwent curative hepatectomy.

Major finding: Compared to NsA therapy, NtA therapy significantly decreased the risk of HCC recurrence (hazard ratio 0.64; P < 0.001) and HCC-related death (HR 0.52; P = 0.001) in patients after surgical resection.

Study details: The data come from a retrospective study of 1,303 adults with hepatitis B-related HCC who received curative hepatectomy at five centers between April 2014 and April 2019.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Qi W et al. Cancer Med. 2021 Oct 13. doi: 10.1002/cam4.4348.

Key clinical point: Nucleotide analog therapy (NtA) significantly reduced risk of HCC recurrence and increased overall survival compared to nucleoside analog therapy (NsA) in patients who underwent curative hepatectomy.

Major finding: Compared to NsA therapy, NtA therapy significantly decreased the risk of HCC recurrence (hazard ratio 0.64; P < 0.001) and HCC-related death (HR 0.52; P = 0.001) in patients after surgical resection.

Study details: The data come from a retrospective study of 1,303 adults with hepatitis B-related HCC who received curative hepatectomy at five centers between April 2014 and April 2019.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Qi W et al. Cancer Med. 2021 Oct 13. doi: 10.1002/cam4.4348.

Key clinical point: Nucleotide analog therapy (NtA) significantly reduced risk of HCC recurrence and increased overall survival compared to nucleoside analog therapy (NsA) in patients who underwent curative hepatectomy.

Major finding: Compared to NsA therapy, NtA therapy significantly decreased the risk of HCC recurrence (hazard ratio 0.64; P < 0.001) and HCC-related death (HR 0.52; P = 0.001) in patients after surgical resection.

Study details: The data come from a retrospective study of 1,303 adults with hepatitis B-related HCC who received curative hepatectomy at five centers between April 2014 and April 2019.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Qi W et al. Cancer Med. 2021 Oct 13. doi: 10.1002/cam4.4348.

Key clinical point: Patients with recurrent hepatocellular carcinoma had increased recurrence-free survival after rHR compared to RFA, but significantly lower morbidity and shorter hospital stays with RFA compared to rHR; overall survival rates were not significantly different between groups.

Major finding: The median recurrence-free survival was longer in recurrent HCC patients treated with rHR compared to RFA (23.6 months vs 15.2 months, hazard ratio 0.76). However, RFA was significantly association with lower morbidity of grade 3 and above (0.6% vs 6.2%) and with a shorter hospital stay (8.0 days vs 3.0 days) compared to rHR.

Study details: The data come from a retrospective, multicenter study including 847 HCC patients; of these, 307 underwent repeat hepatic resection (rHR) and 540 underwent radiofrequency ablation (RFA) between January 2003 and January 2018.

Disclosures: The study was supported by the Natural Science Foundation of China, the China Postdoctoral Science Foundation, the Guangxi BaGui Scholars’ Special Fund, the Gunagxi Natural Science Foundation, and the Science Research and Technology Development Programme of Guangxi. The researchers had no financial conflicts to disclose.

Source: Zhong J-H et al. Br J Surg. 2021 Oct 13. doi: 10.1093/bjs/znab340.

Key clinical point: Patients with recurrent hepatocellular carcinoma had increased recurrence-free survival after rHR compared to RFA, but significantly lower morbidity and shorter hospital stays with RFA compared to rHR; overall survival rates were not significantly different between groups.

Major finding: The median recurrence-free survival was longer in recurrent HCC patients treated with rHR compared to RFA (23.6 months vs 15.2 months, hazard ratio 0.76). However, RFA was significantly association with lower morbidity of grade 3 and above (0.6% vs 6.2%) and with a shorter hospital stay (8.0 days vs 3.0 days) compared to rHR.

Study details: The data come from a retrospective, multicenter study including 847 HCC patients; of these, 307 underwent repeat hepatic resection (rHR) and 540 underwent radiofrequency ablation (RFA) between January 2003 and January 2018.

Disclosures: The study was supported by the Natural Science Foundation of China, the China Postdoctoral Science Foundation, the Guangxi BaGui Scholars’ Special Fund, the Gunagxi Natural Science Foundation, and the Science Research and Technology Development Programme of Guangxi. The researchers had no financial conflicts to disclose.

Source: Zhong J-H et al. Br J Surg. 2021 Oct 13. doi: 10.1093/bjs/znab340.

Key clinical point: Patients with recurrent hepatocellular carcinoma had increased recurrence-free survival after rHR compared to RFA, but significantly lower morbidity and shorter hospital stays with RFA compared to rHR; overall survival rates were not significantly different between groups.

Major finding: The median recurrence-free survival was longer in recurrent HCC patients treated with rHR compared to RFA (23.6 months vs 15.2 months, hazard ratio 0.76). However, RFA was significantly association with lower morbidity of grade 3 and above (0.6% vs 6.2%) and with a shorter hospital stay (8.0 days vs 3.0 days) compared to rHR.

Study details: The data come from a retrospective, multicenter study including 847 HCC patients; of these, 307 underwent repeat hepatic resection (rHR) and 540 underwent radiofrequency ablation (RFA) between January 2003 and January 2018.

Disclosures: The study was supported by the Natural Science Foundation of China, the China Postdoctoral Science Foundation, the Guangxi BaGui Scholars’ Special Fund, the Gunagxi Natural Science Foundation, and the Science Research and Technology Development Programme of Guangxi. The researchers had no financial conflicts to disclose.

Source: Zhong J-H et al. Br J Surg. 2021 Oct 13. doi: 10.1093/bjs/znab340.

Key clinical point: The Liver Imaging Reporting and Data System (LI-RADS) treatment response algorithm (TRA) effectively predicted tumor necrosis in patients treated for HCC with SBRT.

Major finding: The sensitivity was 71%-86% and specificity was 85%-96% for incomplete tumor necrosis of lesions treated with SBRT when the LR-TR Equivocal category was nonviable. When the LR-TR Equivocal category was viable, sensitivity was 88%-96% and specificity was

Study details: The data come from a retrospective study of 40 lesions treated with Stereotactic Body Radiation Therapy (SBRT) in 26 adult patients with HCC.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Mendiratta-Lala M et al. Int J Radiat Oncol Biol Phys. 2021 Oct 10. doi: 10.1016/j.ijrobp.2021.10.006.

Key clinical point: The Liver Imaging Reporting and Data System (LI-RADS) treatment response algorithm (TRA) effectively predicted tumor necrosis in patients treated for HCC with SBRT.

Major finding: The sensitivity was 71%-86% and specificity was 85%-96% for incomplete tumor necrosis of lesions treated with SBRT when the LR-TR Equivocal category was nonviable. When the LR-TR Equivocal category was viable, sensitivity was 88%-96% and specificity was

Study details: The data come from a retrospective study of 40 lesions treated with Stereotactic Body Radiation Therapy (SBRT) in 26 adult patients with HCC.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Mendiratta-Lala M et al. Int J Radiat Oncol Biol Phys. 2021 Oct 10. doi: 10.1016/j.ijrobp.2021.10.006.

Key clinical point: The Liver Imaging Reporting and Data System (LI-RADS) treatment response algorithm (TRA) effectively predicted tumor necrosis in patients treated for HCC with SBRT.

Major finding: The sensitivity was 71%-86% and specificity was 85%-96% for incomplete tumor necrosis of lesions treated with SBRT when the LR-TR Equivocal category was nonviable. When the LR-TR Equivocal category was viable, sensitivity was 88%-96% and specificity was

Study details: The data come from a retrospective study of 40 lesions treated with Stereotactic Body Radiation Therapy (SBRT) in 26 adult patients with HCC.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Mendiratta-Lala M et al. Int J Radiat Oncol Biol Phys. 2021 Oct 10. doi: 10.1016/j.ijrobp.2021.10.006.

Key clinical point: The Liver Imaging Reporting and Data System (LI-RADS) treatment response algorithm (TRA) effectively predicted tumor necrosis in patients treated for HCC with SBRT.

Major finding: The sensitivity was 71%-86% and specificity was 85%-96% for incomplete tumor necrosis of lesions treated with SBRT when the LR-TR Equivocal category was nonviable. When the LR-TR Equivocal category was viable, sensitivity was 88%-96% and specificity was

Study details: The data come from a retrospective study of 40 lesions treated with Stereotactic Body Radiation Therapy (SBRT) in 26 adult patients with HCC.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Mendiratta-Lala M et al. Int J Radiat Oncol Biol Phys. 2021 Oct 10. doi: 10.1016/j.ijrobp.2021.10.006.

Key clinical point: The Liver Imaging Reporting and Data System (LI-RADS) treatment response algorithm (TRA) effectively predicted tumor necrosis in patients treated for HCC with SBRT.

Major finding: The sensitivity was 71%-86% and specificity was 85%-96% for incomplete tumor necrosis of lesions treated with SBRT when the LR-TR Equivocal category was nonviable. When the LR-TR Equivocal category was viable, sensitivity was 88%-96% and specificity was

Study details: The data come from a retrospective study of 40 lesions treated with Stereotactic Body Radiation Therapy (SBRT) in 26 adult patients with HCC.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Mendiratta-Lala M et al. Int J Radiat Oncol Biol Phys. 2021 Oct 10. doi: 10.1016/j.ijrobp.2021.10.006.

Key clinical point: The Liver Imaging Reporting and Data System (LI-RADS) treatment response algorithm (TRA) effectively predicted tumor necrosis in patients treated for HCC with SBRT.

Major finding: The sensitivity was 71%-86% and specificity was 85%-96% for incomplete tumor necrosis of lesions treated with SBRT when the LR-TR Equivocal category was nonviable. When the LR-TR Equivocal category was viable, sensitivity was 88%-96% and specificity was

Study details: The data come from a retrospective study of 40 lesions treated with Stereotactic Body Radiation Therapy (SBRT) in 26 adult patients with HCC.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Mendiratta-Lala M et al. Int J Radiat Oncol Biol Phys. 2021 Oct 10. doi: 10.1016/j.ijrobp.2021.10.006.

Key clinical point: A combination of hepatic artery infusion chemotherapy (HAIC), anti-PD-1 immunotherapy, and tyrosine kinase inhibitors (TKIs) yielded a median of 10.6 months for progression-free survival with no treatment-related deaths over a 4- to 24-month follow-up period in advanced HCC patients.

Major finding: Combination chemotherapy and immunotherapy resulted in a median progression-free survival of 10.6 months with a median 12.9 months’ follow up; objective response rates and disease control rates were 63.0 and 92.6%, respectively.

Study details: The data come from a retrospective study of 27 adults with advanced hepatocellular carcinoma treated between May 2019 and November 2020 in a single center. Patients received hepatic artery infusion chemotherapy (HAIC), anti-PD-1 immunotherapy, and tyrosine kinase inhibitors (TKIs). 

Disclosures: The study was supported by the National Key R and D Program of China, the Key Projects of CSCO-Bayer Cancer Research Fund, the Beijing Municipal Science and Technology Commission, and the National Natural Science Foundation of China. The researchers had no financial conflicts to disclose.

Source: Liu B-J et al. Immunotherapy. 2021 Oct 5. doi: 10.2217/imt-2021-0192. 

Key clinical point: A combination of hepatic artery infusion chemotherapy (HAIC), anti-PD-1 immunotherapy, and tyrosine kinase inhibitors (TKIs) yielded a median of 10.6 months for progression-free survival with no treatment-related deaths over a 4- to 24-month follow-up period in advanced HCC patients.

Major finding: Combination chemotherapy and immunotherapy resulted in a median progression-free survival of 10.6 months with a median 12.9 months’ follow up; objective response rates and disease control rates were 63.0 and 92.6%, respectively.

Study details: The data come from a retrospective study of 27 adults with advanced hepatocellular carcinoma treated between May 2019 and November 2020 in a single center. Patients received hepatic artery infusion chemotherapy (HAIC), anti-PD-1 immunotherapy, and tyrosine kinase inhibitors (TKIs). 

Disclosures: The study was supported by the National Key R and D Program of China, the Key Projects of CSCO-Bayer Cancer Research Fund, the Beijing Municipal Science and Technology Commission, and the National Natural Science Foundation of China. The researchers had no financial conflicts to disclose.

Source: Liu B-J et al. Immunotherapy. 2021 Oct 5. doi: 10.2217/imt-2021-0192. 

Key clinical point: A combination of hepatic artery infusion chemotherapy (HAIC), anti-PD-1 immunotherapy, and tyrosine kinase inhibitors (TKIs) yielded a median of 10.6 months for progression-free survival with no treatment-related deaths over a 4- to 24-month follow-up period in advanced HCC patients.

Major finding: Combination chemotherapy and immunotherapy resulted in a median progression-free survival of 10.6 months with a median 12.9 months’ follow up; objective response rates and disease control rates were 63.0 and 92.6%, respectively.

Study details: The data come from a retrospective study of 27 adults with advanced hepatocellular carcinoma treated between May 2019 and November 2020 in a single center. Patients received hepatic artery infusion chemotherapy (HAIC), anti-PD-1 immunotherapy, and tyrosine kinase inhibitors (TKIs). 

Disclosures: The study was supported by the National Key R and D Program of China, the Key Projects of CSCO-Bayer Cancer Research Fund, the Beijing Municipal Science and Technology Commission, and the National Natural Science Foundation of China. The researchers had no financial conflicts to disclose.

Source: Liu B-J et al. Immunotherapy. 2021 Oct 5. doi: 10.2217/imt-2021-0192. 

Key clinical point: Cabozatinib significantly improved overall survival and progression-free survival in HCC patients with ALBI grades 1 and 2 compared with placebo.

Major finding: Median overall survival in HCC patients with ALBI grade 1 was 17.5 months for in the cabozantinib group vs 11.4 months in the placebo group; median overall survival in patients with ALBI grade 2 was 8.0 months in the cabozantinib group vs 6.4 months in the placebo group.

Study details: The data come from a randomized trial of 707 adults with HCC with albumin-bilirubin (ALBI) grades 1 or 2 at baseline who received 60 mg of cabozantinib daily or a placebo.

Disclosures: The study was supported by Exelixis. Lead author Dr. Kelley disclosed relationships with multiple companies including Exelixis.

Source: Kelley RK et al. Br J Cancer. 2021 Oct 7. doi: 10.1038/s41416-021-01532-5.

Key clinical point: Cabozatinib significantly improved overall survival and progression-free survival in HCC patients with ALBI grades 1 and 2 compared with placebo.

Major finding: Median overall survival in HCC patients with ALBI grade 1 was 17.5 months for in the cabozantinib group vs 11.4 months in the placebo group; median overall survival in patients with ALBI grade 2 was 8.0 months in the cabozantinib group vs 6.4 months in the placebo group.

Study details: The data come from a randomized trial of 707 adults with HCC with albumin-bilirubin (ALBI) grades 1 or 2 at baseline who received 60 mg of cabozantinib daily or a placebo.

Disclosures: The study was supported by Exelixis. Lead author Dr. Kelley disclosed relationships with multiple companies including Exelixis.

Source: Kelley RK et al. Br J Cancer. 2021 Oct 7. doi: 10.1038/s41416-021-01532-5.

Key clinical point: Cabozatinib significantly improved overall survival and progression-free survival in HCC patients with ALBI grades 1 and 2 compared with placebo.

Major finding: Median overall survival in HCC patients with ALBI grade 1 was 17.5 months for in the cabozantinib group vs 11.4 months in the placebo group; median overall survival in patients with ALBI grade 2 was 8.0 months in the cabozantinib group vs 6.4 months in the placebo group.

Study details: The data come from a randomized trial of 707 adults with HCC with albumin-bilirubin (ALBI) grades 1 or 2 at baseline who received 60 mg of cabozantinib daily or a placebo.

Disclosures: The study was supported by Exelixis. Lead author Dr. Kelley disclosed relationships with multiple companies including Exelixis.

Source: Kelley RK et al. Br J Cancer. 2021 Oct 7. doi: 10.1038/s41416-021-01532-5.

Key clinical point: Barcelona Clinic Liver Cancer staging is applicable to recurrent HCC and should be used to formulate clinical stage criteria and develop treatment plans.

Major finding: The median time to tumor recurrence differed significantly among the BCLC staging groups A, B, and C (16 months, 10 months, and 6 months, respectively; P < 0.05). Median overall survival also differed significantly among groups A, B, and C (42 months, 22 months, and 13 months, respectively; P < 0.05).

Study details: The data come from a retrospective cohort study of 81 adults with recurrent HCC who were admitted to a single center between January 2013 and December 2017; they were divided into three groups based on the Barcelona Clinic Liver Cancer (BCLC) staging system to compare median time to tumor recurrence and median overall survival.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Yao S-Y et al. World J Clin Cases. 2021 Sep 26. doi: 10.12998/wjcc.v9.i27.8020.

Key clinical point: Barcelona Clinic Liver Cancer staging is applicable to recurrent HCC and should be used to formulate clinical stage criteria and develop treatment plans.

Major finding: The median time to tumor recurrence differed significantly among the BCLC staging groups A, B, and C (16 months, 10 months, and 6 months, respectively; P < 0.05). Median overall survival also differed significantly among groups A, B, and C (42 months, 22 months, and 13 months, respectively; P < 0.05).

Study details: The data come from a retrospective cohort study of 81 adults with recurrent HCC who were admitted to a single center between January 2013 and December 2017; they were divided into three groups based on the Barcelona Clinic Liver Cancer (BCLC) staging system to compare median time to tumor recurrence and median overall survival.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Yao S-Y et al. World J Clin Cases. 2021 Sep 26. doi: 10.12998/wjcc.v9.i27.8020.

Key clinical point: Barcelona Clinic Liver Cancer staging is applicable to recurrent HCC and should be used to formulate clinical stage criteria and develop treatment plans.

Major finding: The median time to tumor recurrence differed significantly among the BCLC staging groups A, B, and C (16 months, 10 months, and 6 months, respectively; P < 0.05). Median overall survival also differed significantly among groups A, B, and C (42 months, 22 months, and 13 months, respectively; P < 0.05).

Study details: The data come from a retrospective cohort study of 81 adults with recurrent HCC who were admitted to a single center between January 2013 and December 2017; they were divided into three groups based on the Barcelona Clinic Liver Cancer (BCLC) staging system to compare median time to tumor recurrence and median overall survival.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Yao S-Y et al. World J Clin Cases. 2021 Sep 26. doi: 10.12998/wjcc.v9.i27.8020.