Study Suggests Immunotherapy May Benefit HCC Patients with Suboptimal Liver Function

Introduction

Hepatocellular carcinoma (HCC) is a common type of liver cancer, and it is estimated that globally, over 800,000 new cases of HCC are diagnosed each year. Treatment options for HCC depend on the stage of the disease, liver function, and other factors. Unresectable HCC with suboptimal liver function remains a therapeutic challenge, and best supportive care (BSC) is often the only option. However, a recent retrospective study published in JAMA Oncology suggests that immunotherapy may offer a safe and effective option for these patients.

Study Overview

The study examined the association between immune checkpoint inhibitor (ICI)–based therapies and overall survival (OS) of patients with unresectable HCC and Child-Pugh class B (CP-B) liver dysfunction. The study included a cohort of 343 patients with CP-B liver dysfunction, who were receiving first-line ICI-based regimens from September 2017 to December 2022 from tertiary care centers across Europe, US, and Asia in routine clinical practice. After applying the inclusion criteria, 187 and 156 patients were left in the ICI and BSC groups, respectively.

Results

The results of the study showed that immunotherapy-based systemic therapy was associated with a significant reduction in the risk of death compared to BSC in patients with unresectable HCC and suboptimal liver function. The median OS was longer in the ICI group (7.50 months; 95% CI, 5.62-11.15) compared with BSC (4.04 months; 95% CI, 3.03-5.03; hazard ratio, 0.59; 95% CI, 0.43-0.80; P < .001). In multivariable analysis, ICI exposure was associated with a reduction of approximately 50% in the risk of death (hazard ratio, 0.55; 95% CI, 0.35-0.86; P < .001).

Discussion

The results of this study suggest that immunotherapy may provide a safe and effective option for patients with unresectable HCC and suboptimal liver function. Patients with unresectable HCC and CP-B liver dysfunction often have limited treatment options, and this study provides comparative evidence of improved survival associated with ICI treatment compared with BSC.

Long-tail Keywords

– Child-Pugh class B liver dysfunction
– Unresectable hepatocellular carcinoma
– Immune checkpoint inhibitor-based therapies
– Best supportive care
– Overall survival
– Multivariable analysis
– Portal vein tumor thrombosis
– Eastern Cooperative Oncology Group performance score
– Alpha-fetoprotein levels

Conclusion

In conclusion, the results of this study provide evidence that ICI-based systemic therapy may be a safe and effective option for patients with unresectable HCC and suboptimal liver function. These findings are significant, as they offer hope for patients who have limited treatment options. However, additional research is needed to confirm these findings and to determine the optimal treatment approach for this patient population.

Originally Post From https://jamanetwork.com/journals/jamaoncology/fullarticle/2821209

Immunotherapy vs Best Supportive Care for Patients With Hepatocellular Cancer With Child …