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
5458 - Baseline characteristics from CLARINET FORTE: Evaluating lanreotide autogel (LAN) 120 mg every 14 days in patients with progressive pancreatic or midgut neuroendocrine tumours during a standard first-line LAN regimen.
Presenter: Philippe Ruszniewski
Session: Poster Display session 2
Resources:
Abstract
1234 - Analysis of PD-1/PD-L1 blockade biomarker and immune infiltrates in Gastroenteropancreatic neuroendocrine carcinoma
Presenter: Jia Zhang Xing
Session: Poster Display session 2
Resources:
Abstract
1517 - Diabetes Is Associated With Pancreatic Neuroendocrine Tumors Growth and Metastasis
Presenter: Zhiyao Fan
Session: Poster Display session 2
Resources:
Abstract
2145 - Investigation of the reclassification of G1/G2 pancreatic neuroendocrine neoplasms by WHO 2017 classification
Presenter: Takahiro Yokose
Session: Poster Display session 2
Resources:
Abstract
3134 - Treatment with somatostatin analogues after radiopeptide therapy
Presenter: Daria Handkiewicz Junak
Session: Poster Display session 2
Resources:
Abstract
2191 - Safety and Tolerability of Surufatinib in Western Patients with Solid Tumors
Presenter: Erika Hamilton
Session: Poster Display session 2
Resources:
Abstract
3253 - The impact of tumour absorbed dosimetry with survival outcomes after peptide receptor radionuclide therapy in metastatic neuroendocrine tumours.
Presenter: Rahul Ladwa
Session: Poster Display session 2
Resources:
Abstract
3581 - Opportunist and Serious Infections in Patients with Neuroendocrine Tumors Treated With Everolimus: A Multicenter Study of Real World Patients
Presenter: Carine Mauro
Session: Poster Display session 2
Resources:
Abstract
5374 - Establishment of Prognostic Nomogram Based on the Metastatic Lymph Nodes Ratio for Patients with Gastric Neuroendocrine Tumour
Presenter: yaobin lin
Session: Poster Display session 2
Resources:
Abstract
3951 - Neutrophil-lymphocyte ratio as an independent predictive factor in Neuroendocrine Neoplasms
Presenter: Sofia Ferreira
Session: Poster Display session 2
Resources:
Abstract