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
4317 - Prognostic factors analysis of 343 patients with adenocarcinoma of esophagogastric junction
Presenter: Yixun Lu
Session: Poster Display session 2
Resources:
Abstract
4099 - Effects of preoperative preparation time on efficacy of neoadjuvant chemotherapy (SOX) in patients with advanced gastric cancer
Presenter: Xinxin Wang
Session: Poster Display session 2
Resources:
Abstract
3769 - The prognostic value of higher absolute lymphocyte counts for patients with surgically resected non-advanced gastric cancer
Presenter: Se Jun Park
Session: Poster Display session 2
Resources:
Abstract
1718 - Trastuzumab and pertuzumab added to neoadjuvant chemoradiotherapy in resectable HER2+ esophageal adenocarcinoma patients: an update on survival and predictive biomarkers in the TRAP study
Presenter: Charlotte Stroes
Session: Poster Display session 2
Resources:
Abstract
5403 - Interim analysis of a phase II trial of perioperative chemotherapy plus avelumab in esophagogastric and gastric adenocarcinoma
Presenter: Thierry Alcindor
Session: Poster Display session 2
Resources:
Abstract
591 - Evaluation of the introduction of primary G-CSF prophylaxis to the FLOT chemotherapy regimen.
Presenter: Kelly-Marie Crampton
Session: Poster Display session 2
Resources:
Abstract
1402 - Subgroup analyses of a randomized two-by-two factorial phase II trial comparing neoadjuvant chemotherapy with 2 and 4 courses of cisplatin/S-1 (CS) and docetaxel/cisplatin/S-1 (DCS) as neoadjuvant chemotherapy for locally advanced gastric cancer
Presenter: Tsutomu Hayashi
Session: Poster Display session 2
Resources:
Abstract
3743 - HER2 Copy Number as Predictor of Disease-Free Survival in HER2-Positive Resectable Gastric Cancer
Presenter: Zimin Liu
Session: Poster Display session 2
Resources:
Abstract
2032 - Effect of neoadjuvant chemotherapy on the Programmed Death-1 pathway in esophageal and gastric cancer
Presenter: Maria Svensson
Session: Poster Display session 2
Resources:
Abstract
4304 - A user-friendly nomogram to predict relapse-free survival (RFS) in western patients with resected gastric cancer (GC)
Presenter: Massimiliano Salati
Session: Poster Display session 2
Resources:
Abstract