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
581P - The associations between afatinib-related adverse events and survival outcomes in patients with lung cancer
Presenter: Wen-Chen Tang
Session: Poster Display
Resources:
Abstract
582P - Furmonertinib treatment in patients with EGFR-mutated non-small cell lung cancer and leptomeningeal metastases: A real-world study
Presenter: Haiyang Chen
Session: Poster Display
Resources:
Abstract
583P - RHBDL2 promotes non-small cell lung cancer metastasis and osimertinib resistance by activating the RAS/MEK/ERK signaling pathway through interaction with FGFR
Presenter: jun Deng
Session: Poster Display
Resources:
Abstract
584P - Upfront aumolertinib for preventing symptomatic central nervous system(CNS) metastases in EGFR-mutant non-small cell lung cancer without baseline CNS metastasis
Presenter: Tangfeng Lv
Session: Poster Display
Resources:
Abstract
585P - Real-world outcomes in patients with non-small cell lung cancer with EGFR exon 20 insertion mutations receiving mobocertinib
Presenter: Tony S.K. Mok
Session: Poster Display
Resources:
Abstract
586P - Clinical validation of a multiplex polymerase chain reaction (mPCR) assay to identify patients (pts) with NSCLC suitable for mobocertinib treatment
Presenter: Caicun Zhou
Session: Poster Display
Resources:
Abstract
587P - Exploring the prevalence and characteristics of human epidermal growth factor receptor 2 (HER2) alterations in non-small cell lung cancer: Analysis from a Malaysian cohort
Presenter: Ning Yi Yap
Session: Poster Display
Resources:
Abstract
588P - First real-world study with HER2 ADC in treating HER2-altered non-small cell lung cancer
Presenter: Kaihua Lu
Session: Poster Display
Resources:
Abstract
590P - A retrospective study of the prevalence and clinical outcomes of KRAS G12C mutated advanced non-small cell lung cancer (NSCLC) in Australian patients (pts)
Presenter: Ben Markman
Session: Poster Display
Resources:
Abstract
591P - The utility of next generation sequencing for KRAS gene variants prevalence in cytological and tissue samples in real-world NSCLC patients: A large single institution real-world study
Presenter: Adam Pluzanski
Session: Poster Display
Resources:
Abstract