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
3159 - Anlotinib for advanced hepatocellular carcinoma: interim results from the phase II ALTER0802 study
Presenter: AiPing Zhou
Session: Poster Display session 2
Resources:
Abstract
3191 - The efficacy and safety of lenvatinib in patients who did not meet the inclusion criteria of the phase 3 trial (REFLECT trial) and those with BCLC Stage B hepatocellular carcinoma - A nationwide multicenter study in Japan-
Presenter: Azusa Sakamoto
Session: Poster Display session 2
Resources:
Abstract
1529 - Prognostic and predictive value of baseline alpha-fetoprotein (AFP) in patients with advanced hepatocellular carcinoma (HCC) treated with ramucirumab from two phase 3 studies (REACH, REACH-2)
Presenter: Andrew Zhu
Session: Poster Display session 2
Resources:
Abstract
2767 - Effect of second-line cabozantinib on health states for patients with advanced hepatocellular carcinoma (aHCC) after sorafenib: QTWiST analysis from the CELESTIAL study
Presenter: Nicholas Freemantle
Session: Poster Display session 2
Resources:
Abstract
2150 - Alpha-fetoprotein (AFP) response in patients with unresectable hepatocellular carcinoma (HCC) in the phase 3 RESORCE trial
Presenter: Jordi Bruix
Session: Poster Display session 2
Resources:
Abstract
3437 - Phase I/II trial of NBTXR3 activated by SBRT in patients with hepatocellular carcinoma or liver metastasis
Presenter: Marc Pracht
Session: Poster Display session 2
Resources:
Abstract
1758 - Efficacy and safety of ramucirumab (RAM) for advanced hepatocellular carcinoma (HCC) with elevated alpha-fetoprotein (AFP) following first-line sorafenib across age subgroups in two global phase 3 trials (REACH and REACH-2)
Presenter: Masatoshi Kudo
Session: Poster Display session 2
Resources:
Abstract
1192 - Ramucirumab in patients with advanced hepatocellular carcinoma (HCC) and elevated alpha fetoprotein (AFP): An exposure–response analysis
Presenter: Josep Llovet
Session: Poster Display session 2
Resources:
Abstract
2364 - Pembrolizumab vs Chemotherapy in Patients With Advanced/Metastatic Adenocarcinoma (AC) or Squamous Cell Carcinoma (SCC) of the Esophagus as Second-Line Therapy: Analysis of the Chinese Subgroup in KEYNOTE-181
Presenter: Jia Chen
Session: Poster Display session 2
Resources:
Abstract
1933 - A national comparative effectiveness study to assess definitive chemoradiation regimens in proximal oesophageal squamous cell cancer
Presenter: Judith de Vos-Geelen
Session: Poster Display session 2
Resources:
Abstract