Abstract 1600
Background
Nivolumab (N), an IgG4 monoclonal antibody to PD-1, yields long-term disease control and prolonged survival in some patients (pts) with HCC, leading to its approval by the FDA in 2017 as 2nd line therapy after sorafenib. We present our institutional experience with N in the treatment of HCC at Mount Sinai Hospital.
Methods
Medical records of HCC pts treated with N until progression or intolerable toxicity between June 2016 and July 2018, were reviewed. Response was evaluated by RECIST 1.1. Overall and Progression free survival (OS, PFS) were estimated by Kaplan-Meier method.
Results
104 pts (84% male, median age 66 [29-89] years) were identified. 24 (23%) pts were Asian, 26(25%) Black, 30(29%) White and 24(23%) unknown. Hep C was the most common risk factor in 50 (48%) pts, followed by Hep B in 34(32%) with co-infection in 7 (6%) pts, NASH in 10 (9%), Alcohol in 8(7%) and other including HIV in 10 (9%)pts. Cirrhosis was present in 83 (80%) pts. Child Pugh score (N = 96) and was A in 64 (67%) and B in 32 (33%) pts. Barcelona Clinic Liver Cancer (BCLC) stage was B in 21 (20%) and C in 83 (80%) pts. 67 (64%) pts received 1st line systemic therapy with N. Among the 37 (36%) treated with N in subsequent lines, 27 (73%) had progressed on Sorafenib. Loco-regional therapies (LRT) including Y90 and TACE were given concurrently with N in 32(31%) pts. The median duration of treatment was 26 (2-149) weeks and median follow up was 17 months (95% CI (15.7, 20.7)). Objective response rate was 20% including 10(10%) complete responders (CR), all of whom received concurrent LRT. 39(37%) pts had progressive disease (PD) and 40(38%) had stable disease (SD). Median duration of response was 9 (1-31) months. Median OS and PFS are shown in the table.Table:
759P
OS (months) | P | PFS(months) | P | |
---|---|---|---|---|
By line: | ||||
First | 23 | 0.1013 | 16 | 0.1394 |
Subsequent | 12 | 6 | ||
By response: | ||||
CR/PR | Not Reached | <0.0001 | ||
SD | 23 | |||
PD | 7 |
Conclusions
HCC pts treated at our institution frequently received N in first line and 31% received concurrent LRT. Survival did not differ statistically between first vs subsequent line N. Our real-world experience with N in HCC appears comparable to data from the checkmate-040 study.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Mount Sinai Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5747 - The routine use of sentinel lymph node biopsy in high risk DCIS lesions is not justified
Presenter: Fanny Preat
Session: Poster Display session 2
Resources:
Abstract
1837 - Oncological impact of re-excision for positive margin status after breast conserving surgery in invasive breast cancer
Presenter: Kenjiro Jimbo
Session: Poster Display session 2
Resources:
Abstract
4347 - Pneumonitis and fibrosis after breast cancer radiation.
Presenter: Jarle Karlsen
Session: Poster Display session 2
Resources:
Abstract
2280 - Prognosis of mastectomy with reconstruction after neoadjuvant chemotherapy: a nationwide study in Korean Breast Cancer Society
Presenter: Sungmin Park
Session: Poster Display session 2
Resources:
Abstract
804 - A negative prognosis of radiotherapy-induced lower lymphocyte to monocyte ratio in patients with breast cancer
Presenter: Chang-ik Yoon
Session: Poster Display session 2
Resources:
Abstract
2701 - Patient data to monitor clinical patterns in early and advanced breast cancer in Europe
Presenter: Francesco Giusti
Session: Poster Display session 2
Resources:
Abstract
1437 - A critical appraisal of quality indicators of breast cancer treatment in Belgium
Presenter: Didier Verhoeven
Session: Poster Display session 2
Resources:
Abstract
1534 - Predictors of adherence among post-menopausal women receiving adjuvant endocrine therapy for breast cancer in Ontario, Canada
Presenter: Phillip Blanchette
Session: Poster Display session 2
Resources:
Abstract
4363 - Evaluation of endocrine therapy and patients preferences in early breast cancer: results of Elena study
Presenter: Emilia Montagna
Session: Poster Display session 2
Resources:
Abstract
2679 - Baseline Quality of life (QoL) and chemotherapy related toxicities (CRT) in localized breast cancer (BC) patients (pts): the French multicentric prospective CANTO cohort study
Presenter: Idlir Licaj
Session: Poster Display session 2
Resources:
Abstract