Abstract 177P
Background
Clinical trials of combined LEN and anti-PD-1 antibodies in advanced HCC have shown promising anti-tumor effects. Although responses of both intra- and extra-hepatic tumors are typically evaluated to assess efficacy of a systemic therapy in HCC, the responses of tumors in different sites or organs can be very heterogeneous.
Methods
A retrospective analysis of patients with advanced, unresectable HCC who received 1L LEN (8 mg/d regardless of bodyweight) plus anti-PD-1 antibodies either q2wk (nivolumab or camrelizumab) or q3wk (pembrolizumab, sintilimab or toripalimab). Patients who completed ≥1 efficacy and safety assessment were eligible for inclusion. Overall objective response rate (ORR) and organ-specific response rate (OSRR) were assessed using RECIST 1.1 and mRECIST. All evaluations were repeated by an independent imaging reviewer.
Results
From Oct 2018 to Mar 2020, 59 patients were assessable for efficacy (median age: 54.3 years; 91.5% males). Among these patients, 2 (3.4%) were BCLC stage A, 11 (18.6%) were BCLC stage B, and 46 (78.0%) were BCLC stage C (including 30 with macroscopic vascular invasion, [China Liver Cancer [CNLC] stage IIIa] and 16 with extrahepatic metastasis or combined with macroscopic vascular invasion [CNLC stage IIIb]). The overall ORR evaluated using RECIST 1.1 and mRECIST was 32.2% and 57.6% according to investigator review, and 33.9% and 50.8% according to independent imaging review, respectively. OSRR was higher in macrovascular tumor thrombi (MVTT, including portal vein and hepatic veins) versus other sites (Table). Five patients with MVTT were successfully converted to liver resection because of downstaging via significant response in MVTT. Table: 177P
Objective response rate, % | RECIST v1.1 (investigator) | RECIST v1.1 (independent imaging review) |
Overall (n=59) | 32.2 | 33.9 |
Organ-specific | ||
Liver (n=57) | 33.0 | 32.0 |
Macrovascular tumor thrombi (n=33) | 57.5 | 51.5 |
Lung (n=7) | 37.5 | 37.5 |
Lymph node (n=6) | 33.3 | 33.3 |
Adrenal gland (n=2) | 100 | 100 |
Intra-abdominal implantation (n=2) | 100 | 100 |
Conclusions
The response of MVTT to combined LEN and anti-PD-1 antibodies was higher versus HCC tumors in other sites. The mechanisms underlying this differential response warrant further investigation.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
143P - Lymph nodes metastasis is the most important factor associated with pattern of recurrence following curative resection of gastric adenocarcinoma
Presenter: Fu-Hai Wang
Session: e-Poster Display Session
144P - Clinical implication of DNA damage response gene in patients with stage II or III gastric cancer
Presenter: In Gyu Hwang
Session: e-Poster Display Session
145P - A nomogram for predicting the benefit of adjuvant chemotherapy after resection in patients with Borrmann type IV gastric cancer
Presenter: Qing-Zhu Qiu
Session: e-Poster Display Session
146P - Red cell distribution width and mean corpuscular volume ratio as a promising new marker for chemotherapy effects in remnant gastric cancer: An analysis of a multi-institutional database
Presenter: Kai-Xiang Xu
Session: e-Poster Display Session
147P - Can the clinical stage of the 8th edition of the Union for International Cancer Control TNM classification stratify prognosis of patients with Siewert type II/III cancer?
Presenter: Hayato Watanabe
Session: e-Poster Display Session
148P - MCV-the ideal answer to predict the prognosis of remnant gastric cancer: An analysis from a multi-institutional database
Presenter: Kai Weng
Session: e-Poster Display Session
149P - Molecular and clinical characteristics of patients with resectable gastric cancer
Presenter: Zhi Zheng
Session: e-Poster Display Session
150P - Real-world assessment of the treatment patterns associated with unresectable advanced and metastatic gastric cancer in China
Presenter: Xiao Sun
Session: e-Poster Display Session
151P - Treatment patterns, healthcare resource use, economic and survival outcomes associated with unresectable advanced metastatic gastric cancers in Taiwan
Presenter: Chee Jen Chang
Session: e-Poster Display Session
152P - ARID1A deficiency in EBV-positive gastric cancer is partially regulated by EBV-encoded miRNAs, but not by DNA promotor hypermethylation
Presenter: Koji Kase
Session: e-Poster Display Session