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Published in: Journal of Cancer Research and Clinical Oncology 1/2019

01-01-2019 | Original Article – Clinical Oncology

Feasibility and safety of nivolumab in advanced hepatocellular carcinoma: real-life experience from three German centers

Authors: Fabian Finkelmeier, Carolin Czauderna, Lukas Perkhofer, Thomas J. Ettrich, Jörg Trojan, Arndt Weinmann, Jens U. Marquardt, Johannes Vermehren, Oliver Waidmann

Published in: Journal of Cancer Research and Clinical Oncology | Issue 1/2019

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Abstract

Introduction

Nivolumab is the first checkpoint-inhibitor approved for the treatment of advanced HCC patients. Real-life experience data of nivolumab treatment in HCC patients, especially those with advanced liver disease, is scarce.

Materials and methods

All patients with confirmed advanced HCC and nivolumab treatment from three large German centers were retrospectively analyzed. Clinical parameters and outcome were assessed.

Results

A total of 34 patients were included. At the time of treatment initiation 5 patients (14.7%) were classified as stage BCLC B and 29 (85.3%) BCLC C, respectively. 25 (73.5) patients had received prior sorafenib treatment. All patients presented with cirrhosis, namely Child–Pugh stages A (56%) or B (41%), respectively. At time of patient’s assessment, 20 out of 34 (58.8%) patients had died. Grade 3 toxicities occurred in two patients (5.9%). Best overall responses were partial response in four patients (11.8%) and stable disease in eight patients (23.5%). The median overall survival of the whole cohort was 7.5 weeks (range 0–46). Child–Pugh B stage disease at treatment start was significantly associated with poor outcome.

Discussion

Nivolumab treatment seems safe and clinical efficacious. Patients with advanced liver disease require further prospective evaluation due to probable limited efficacy of nivolumab.
Literature
go back to reference El-Khoueiry AB, Melero I, Yau TC, Crocenzi TS, Kudo M, Hsu C et al (2018) Impact of antitumor activity on survival outcomes, and nonconventional benefit, with nivolumab (NIVO) in patients with advanced hepatocellular carcinoma (aHCC): Subanalyses of CheckMate-040. In: Abstract presented at the 2018 ASCO GI. https://meetinglibrary.asco.org/record/156075/abstract El-Khoueiry AB, Melero I, Yau TC, Crocenzi TS, Kudo M, Hsu C et al (2018) Impact of antitumor activity on survival outcomes, and nonconventional benefit, with nivolumab (NIVO) in patients with advanced hepatocellular carcinoma (aHCC): Subanalyses of CheckMate-040. In: Abstract presented at the 2018 ASCO GI. https://​meetinglibrary.​asco.​org/​record/​156075/​abstract
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go back to reference Sangro B, Melero I, Yau T, Hsu C, Kudo M, Kim T-Y et al (2017) Nivolumab in sorafenib-naive and experienced patients with advanced hepatocellular carcinoma (HCC): survival, hepatic safety, and biomarker assessments in CheckMate 040. Hepatology 66(S1):1–148. https://doi.org/10.1002/hep.29500 CrossRef Sangro B, Melero I, Yau T, Hsu C, Kudo M, Kim T-Y et al (2017) Nivolumab in sorafenib-naive and experienced patients with advanced hepatocellular carcinoma (HCC): survival, hepatic safety, and biomarker assessments in CheckMate 040. Hepatology 66(S1):1–148. https://​doi.​org/​10.​1002/​hep.​29500 CrossRef
Metadata
Title
Feasibility and safety of nivolumab in advanced hepatocellular carcinoma: real-life experience from three German centers
Authors
Fabian Finkelmeier
Carolin Czauderna
Lukas Perkhofer
Thomas J. Ettrich
Jörg Trojan
Arndt Weinmann
Jens U. Marquardt
Johannes Vermehren
Oliver Waidmann
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
Journal of Cancer Research and Clinical Oncology / Issue 1/2019
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-018-2780-8

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