Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 19;9(9):2682.
doi: 10.3390/jcm9092682.

Immune Checkpoint Inhibitors versus VEGF Targeted Therapy as Second Line Regimen in Advanced Hepatocellular Carcinoma (HCC): A Retrospective Study

Anwaar Saeed  1 , Hannah Hildebrand  1 , Robin Park  2 , Mohammed Al-Jumayli  3 , Saqib Abbasi  1 , Tina Melancon  1 , Azhar Saeed  4 , Raed Al-Rajabi  1 , Anup Kasi  1 , Joaquina Baranda  1 , Stephen Williamson  1 , Weijing Sun  1
Affiliations

Immune Checkpoint Inhibitors versus VEGF Targeted Therapy as Second Line Regimen in Advanced Hepatocellular Carcinoma (HCC): A Retrospective Study

Anwaar Saeed et al. J Clin Med. .

Abstract

Several targeted agents including multi-tyrosine kinase inhibitors (mTKIs) and immunotherapy (IO) agents have been approved for use beyond the frontline setting in patients with advanced hepatocellular carcinoma (HCC). Due to lack of prospective head-to-head comparative trials, there is no standardized way for alternating those agents beyond frontline. Therefore, we performed a retrospective review of the Kansas University (KU) cancer registry to determine whether IO may be superior to non-IO therapy. Patients with advanced HCC were divided into two groups based on the second-line systemic regimen received (IO vs. non-IO). Progression-free survival (PFS) and overall survival (OS) were calculated under the Kaplan-Meier and Cox proportional hazards models. No statistically significant differences in PFS and OS were found, although a non-significant delayed separation in the survival curve favoring IO was identified (median PFS 3.9 months vs. 3 months; median OS 10 months vs. 10 months respectively for IO vs. non-IO). This retrospective analysis is one of the earliest and largest studies comparing second-line IO and non-IO therapies thus far reported. Future studies should aim to define specific biomarkers for response prediction and treatment optimization based on individual patient and tumor characteristics. Furthermore, combinatorial therapeutic strategies is an evolving approach showing early promising signal.

Keywords: Program Death Ligand 1; checkpoint inhibitors; hepatocellular carcinoma; immunotherapy; multi-tyrosine kinase inhibitors; targeted therapy.

PubMed Disclaimer

Conflict of interest statement

Anwaar Saeed reports research grants (to institution) from Astrazeneca, Bristol Myers Squibb, Exelixis, Clovis, and Merck as well as advisory board/consultant fees from Bristol Myers Squibb, Astrazeneca, Merck, and Exelixis. Raed Al-Rajabi reports research grants (to institution) from Merck and Astrazeneca. Joaquina Baranda reports research grants (to institution) from Exelixis. Stephen Williamson reports research grants (to institution) from Bristol Myers Squibb and Merck. Weijing Sun reports research grants (to institution) from Merck and Astrazeneca as well as advisory board/consultant fees from Bayer. The remaining authors report no conflict of interest.

Figures

Figure 1
Figure 1
Progression-free survival in immunotherapy (IO) versus non-IO subgroups. The blue line represents the non-IO whereas the red line represents the IO population.
Figure 2
Figure 2
Overall survival in IO versus non-IO patients. The blue line represents the non-IO whereas the red line represents the IO population.
Figure 3
Figure 3
Progression-free survival in hepatitis C virus (HCV)-positive hepatocellular carcinoma (HCC) patients in IO versus non-IO subgroups. The blue line represents the non-IO whereas the red line represents the IO population.
Figure 4
Figure 4
Overall survival in HCV-positive HCC patients in IO versus non-IO subgroups. The blue line represents the non-IO whereas the red line represents the IO population.
See this image and copyright information in PMC

References

    1. Cronin K.A., Lake A.J., Scott S., Sherman R.L., Noone A.M., Howlader N., Henley S.J., Anderson R.N., Firth A.U., Ma J., et al. Annual Report to the Nation on the Status of Cancer, part I: National cancer statistics. Cancer. 2018;124:2785–2800. doi: 10.1002/cncr.31551. - DOI - PMC - PubMed
    1. Bray F., Ferlay J., Soerjomataram I., Siegel R.L., Torre L.A., Jemal A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J. Clin. 2018;68:394–424. doi: 10.3322/caac.21492. - DOI - PubMed
    1. Akinyemiju T., Abera S., Ahmed M., Alam N., Alemayohu M.A., Allen C., Al-Raddadi R., Alvis-Guzman N., Amoako Y., Artaman A., et al. The Burden of Primary Liver Cancer and Underlying Etiologies From 1990 to 2015 at the Global, Regional, and National Level: Results From the Global Burden of Disease Study 2015. JAMA Oncol. 2017;3:1683–1691. doi: 10.1001/jamaoncol.2017.3055. - DOI - PMC - PubMed
    1. Capuano G., Daniele B., Gaeta G.B., Gallo C., Perrone F. A New Prognostic System for Hepatocellular Carcinoma: A Retrospective Study of 435 Patients: The Cancer of the Liver Italian Program (CLIP) Investigators. Hepatology. 1998;28:751–755. doi: 10.1002/hep.510280322. - DOI - PubMed
    1. Kudo M., Finn R.S., Qin S., Han K.H., Ikeda K., Piscaglia F., Baron A., Park J.W., Han G., Jassem J., et al. Lenvatinib Versus Sorafenib In First-line Treatment of Patients With Unresectable Hepatocellular Carcinoma: A Randomised Phase 3 Non-inferiority Trial. Lancet. 2018;391:1163–1173. doi: 10.1016/S0140-6736(18)30207-1. - DOI - PubMed

LinkOut - more resources