Abstract 185P
Background
The impact of etiology on response to immunotherapy in advanced hepatocellular carcinoma (HCC) is being extensively debated. Early clinical trials suggested that PD-1/PD-L1 blockade prolonged survival of viral HCC patients, but not of those with non-viral HCC. However, a recent post-hoc analysis of the IMbrave-150 trial showed atezolizumab plus bevacizumab (AB) to exhibit similar efficacy in viral and non-viral groups. Here we investigated the role of etiology in AB-treated HCC patients in a real-world scenario to consolidate these findings and integrate them with previous comparative studies with lenvatinib.
Methods
We retrospectively analyzed 885 HCC patients treated with first-line AB from Eastern and Western countries, 53.9% having viral and 46.1% non-viral etiology. Baseline clinical and laboratory characteristics were analyzed with uni- and multi-variate models to assess the impact of etiology on overall survival (OS), time to progression (TTP), response rates and to identify prognostic factors in etiology subgroups.
Results
Overall, no statistically significant differences were found in OS (mOS: viral 15.9mo; non-viral 16.3mo), TTP (mTTP: viral 8.3mo; non-viral 7.2mo), and response rates based on etiology. However, certain prognostic factors differed between the two groups. Among patients with viral etiology, eosinophil count positively correlated with OS, while among non-viral patients AST and ALP levels were significantly related to OS. AFP, NLR, and ALBI score were prognostic for both groups. The toxicity profile of AB almost overlaps in the two etiology subgroups.
Conclusions
These findings indicate that underlying etiology does not significantly impact the outcome of HCC patients treated with AB. However, some prognostic factors differ between viral and non-viral patients, with immunological factors being mostly related to the former while metabolic to the latter, supporting potential biological differences. This may also account for different outcomes of AB observed in comparative studies with lenvatinib in etiology subgroups. Prospective and comparative trials stratifying by etiology are warranted to validate these findings and guide clinical practice.
Clinical trial identification
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
F. Finkelmeier: Financial Interests, Personal, Speaker, Consultant, Advisor: AbbVie, MSD, Ipsen, Esai and Fresenius. M. Scartozzi: Financial Interests, Personal, Speaker, Consultant, Advisor: Amgen, MSD, Merck, BMS, Servier, Eisai, GSK. A. Casadei Gardini: Financial Interests, Personal, Speaker, Consultant, Advisor: MSD, Eisai, Bayer, Bristol Myers Squibb, AstraZeneca and GSK. All other authors have declared no conflicts of interest.
Resources from the same session
239P - Elevated baseline C-reactive protein is a prognostic indicator for OS in patients with metastatic non clear cell renal cell carcinoma treated with systemic therapy
Presenter: Ryuichi Mizuno
Session: Poster Display
Resources:
Abstract
240P - Efficacy and safety of first-line combination therapy with ipilimumab + nivolumab for metastatic renal cell carcinoma in a single institution in Japan
Presenter: Naoya Nagaya
Session: Poster Display
Resources:
Abstract
241P - First-line cabozantinib in metastatic renal cell carcinoma (mRCC): A real-world exploratory study from eastern India
Presenter: Tamojit Chaudhuri
Session: Poster Display
Resources:
Abstract
244P - Clinicopathologic feature and treatment outcome of metastatic non clear cell kidney cancer: A single centre experience from India
Presenter: Somnath Roy
Session: Poster Display
Resources:
Abstract
245P - The role of TGF-β in the formation of the protumor phenotype of circulating neutrophils at different stages of renal cancer
Presenter: Ilseya Myagdieva
Session: Poster Display
Resources:
Abstract
246P - Impact of renal impairment on first-line treatment in metastatic urothelial cancer
Presenter: Stephanie Wakeling
Session: Poster Display
Resources:
Abstract
247P - Adjuvant chemoradiotherapy in the management of bladder adenocarcinoma compared to multiple treatment modalities
Presenter: Othman Mohammed
Session: Poster Display
Resources:
Abstract
248P - Screening zinc homeostasis-related genes identifies metallothionein 1H (MT1H) as a potential prognostic biomarker in clear cell renal cell carcinoma (ccRCC)
Presenter: Eyad Al Masoud
Session: Poster Display
Resources:
Abstract
249P - The prognostic utility of Progestogen associated Endometrial protein (PAEP) gene expression in clear cell renal cell carcinoma (ccRCC)
Presenter: Leen Lataifeh
Session: Poster Display
Resources:
Abstract
250P - Impact of adjuvant chemo(radio)therapy in stage I/II testicular seminoma
Presenter: Mahmoud Eleisawy
Session: Poster Display
Resources:
Abstract