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Adjuvant Immune Checkpoint Inhibitors Associated with Higher Recurrence-free Survival in Postoperative Hepatocellular Carcinoma (PREVENT): a Prospective, Multicentric Cohort Study

Overview
Journal J Gastroenterol
Specialty Gastroenterology
Date 2023 Jul 14
PMID 37452107
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Abstract

Background: Adjuvant therapy may improve survival of patients with hepatocellular carcinoma (HCC) after curative resection. This study compared safety and efficacy outcomes between patients at high risk of recurrence who received different types of adjuvant therapy or no such therapy after hepatic resection for HCC.

Methods: Recurrence-free survival (RFS), overall survival, and adverse events were compared among patients who received adjuvant immune checkpoint inhibitors (ICIs) alone, ICIs with tyrosine kinase inhibitors (TKIs), or no adjuvant therapy between 13 March 2019 and 19 March 2022. This study was registered on ClinicalTrials.gov (NCT05221398).

Results: Of the 517 patients in final analysis, 432 (83.6%) received no adjuvant therapy, 53 (10.2%) received ICIs alone, and 32 (6.2%) received adjuvant ICIs and TKIs. During median follow-up of 34.0 months (IQR 27.8 to 41.6 months), RFS was significantly longer among patients who received either type of adjuvant therapy (25.2 months, 95%CI 16.4-34.0) than among those who received none (16.1 months, 95%CI 12.9-19.4), and this difference remained significant after propensity score matching (HR 0.52, 95%CI 0.35-0.76, P = 0.004). Overall survival was unaffected by either type of adjuvant therapy, while significant difference was observed between patients who received adjuvant therapy or not after propensity score matching (HR 0.31, 95%CI 0.17-0.59, P = 0.005). The rate of grade 3 or 4 adverse events was similar between the two types of adjuvant therapy.

Conclusions: ICIs alone or with TKIs may improve RFS of patients at high risk of HCC recurrence after curative resection.

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References
1.
Reig M, Forner A, Rimola J, Ferrer-Fabrega J, Burrel M, Garcia-Criado A . BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. J Hepatol. 2021; 76(3):681-693. PMC: 8866082. DOI: 10.1016/j.jhep.2021.11.018. View

2.
Kudo M, Kawamura Y, Hasegawa K, Tateishi R, Kariyama K, Shiina S . Management of Hepatocellular Carcinoma in Japan: JSH Consensus Statements and Recommendations 2021 Update. Liver Cancer. 2021; 10(3):181-223. PMC: 8237791. DOI: 10.1159/000514174. View

3.
Zhou J, Sun H, Wang Z, Cong W, Wang J, Zeng M . Guidelines for the Diagnosis and Treatment of Hepatocellular Carcinoma (2019 Edition). Liver Cancer. 2021; 9(6):682-720. PMC: 7768108. DOI: 10.1159/000509424. View

4.
Gordan J, Kennedy E, Abou-Alfa G, Beg M, Brower S, Gade T . Systemic Therapy for Advanced Hepatocellular Carcinoma: ASCO Guideline. J Clin Oncol. 2020; 38(36):4317-4345. DOI: 10.1200/JCO.20.02672. View

5.
Hack S, Spahn J, Chen M, Cheng A, Kaseb A, Kudo M . IMbrave 050: a Phase III trial of atezolizumab plus bevacizumab in high-risk hepatocellular carcinoma after curative resection or ablation. Future Oncol. 2020; 16(15):975-989. DOI: 10.2217/fon-2020-0162. View