Liver Cancer: The impact of immune-related adverse events (irAEs) on the efficacy of immune checkpoint inhibitors (ICIs) in patients with advanced hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second leading cause of cancer-related death in the world
.

Hepatocellular carcinoma can be treated by surgery, local or systemic treatment

Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second leading cause of cancer-related death in the world

The study conducted a retrospective study of aHCC patients who received at least one dose of ICI at the Singapore National Cancer Center from May 2015 to November 2019
.

The main purpose of the study is to compare the overall survival (OS) and progression-free survival (PFS) of patients with and without irAEs

The study conducted a retrospective study of aHCC patients who received at least one dose of ICI at the Singapore National Cancer Center from May 2015 to November 2019

168 patients were included in this study

Ninety-seven patients (57.

Compared with patients without irAEs, patients with any grade of irAEs had significantly higher ORR (27.

ORR and DCR

ORR and DCR

Compared with patients without irAEs, patients with any grade of irAEs have a longer median progression-free survival (PFS) (5.
5 months [95% CI: 3.
4-8.
2] vs.
1.
3 months [95% CI: 1.
1-1.
6] ], hazard ratio (HR) 0.
43 [95% CI: 0.
31-0.
61], p<0.
001)
.

The median progression-free survival of patients with ≥ grade 3 irAE vs.

Compared with patients without irAEs, patients with any grade of irAEs have a longer median progression-free survival (PFS) (5.

            PFS and OS

PFS and OS

Compared with patients without irAEs, the median OS of patients with any grade of irAEs was significantly longer (16.
2 months [95% CI: 13.
9-20.
7] vs.
4.
6 months [95% CI: 3.
2-5.
7], HR 0.
45 [95 % CI: 0.
31 0.
66], p<0.
001)
.

The median OS of patients with ≥ grade 3 irAE vs.

Compared with patients without irAEs, the median OS of patients with any grade of irAEs was significantly longer (16.

          PFS and OS related factors

  PFS and OS related factors

Among patients with irAEs, patients who received systemic steroid therapy had a tendency to prolong progression-free survival (9.
9 months [95% CI: 7.
8-17.
8] compared with 3.
4 months [95] compared with patients who did not receive systemic steroid therapy.
% CI: 1.
8-5.
5], HR=0.
75 [95% CI: 0.
46 1.
21], p = 0.
238)
.

OS has the same trend (20.
7 months [95% CI: 15.
3-NE] vs.
14.
3 months [95% CI: 9.
6 21.
0], HR=0.
59 [95% CI: 0.
33-1.
04], p = 0.
068)
.
The initial systemic steroid dose has no effect on PFS or OS
.
However, the duration of systemic steroids has an impact
.
Compared with patients who received steroid therapy for less than 60 days, patients who received systemic steroid therapy for ≥60 days had prolonged PFS and OS
.

Among patients with irAEs, patients who received systemic steroid therapy had a tendency to prolong progression-free survival (9.
9 months [95% CI: 7.
8-17.
8] compared with 3.
4 months [95] compared with patients who did not receive systemic steroid therapy.
% CI: 1.
8-5.
5], HR=0.
75 [95% CI: 0.
46 1.
21], p = 0.
238)
.
OS has the same trend (20.
7 months [95% CI: 15.
3-NE] vs.
14.
3 months [95% CI: 9.
6 21.
0], HR=0.
59 [95% CI: 0.
33-1.
04], p = 0.
068)
.
The initial systemic steroid dose has no effect on PFS or OS
.
However, the duration of systemic steroids has an impact
.
Compared with patients who received steroid therapy for less than 60 days, patients who received systemic steroid therapy for ≥60 days had prolonged PFS and OS
.
Among patients with irAEs, patients who received systemic steroid therapy had a tendency to prolong progression-free survival (9.
9 months [95% CI: 7.
8-17.
8] compared with 3.
4 months [95] compared with patients who did not receive systemic steroid therapy.
% CI: 1.
8-5.
5], HR=0.
75 [95% CI: 0.
46 1.
21], p = 0.
238)
.
OS has the same trend (20.
7 months [95% CI: 15.
3-NE] vs.
14.
3 months [95% CI: 9.
6 21.
0], HR=0.
59 [95% CI: 0.
33-1.
04], p = 0.
068)
.
The initial systemic steroid dose has no effect on PFS or OS
.
However, the duration of systemic steroids has an impact
.
Compared with patients who received steroid therapy for less than 60 days, patients who received systemic steroid therapy for ≥60 days had prolonged PFS and OS
.

In summary, studies have shown that in aHCC patients treated with ICI, the appearance of irAEs may be a potential prognostic marker
.
The more severe the irAEs, the better the prognosis of patients with multiple systems
.
Timely use of systemic corticosteroids to treat irAEs is the key to ensuring the best long-term prognosis for these patients
.

In summary, studies have shown that in aHCC patients treated with ICI, the appearance of irAEs may be a potential prognostic marker
.
The more serious the irAEs, the better the prognosis of patients with multiple systems
.
Timely use of systemic corticosteroids to treat irAEs is the key to ensuring the best long-term prognosis for these patients
.
Studies have shown that in aHCC patients treated with ICI, the appearance of irAEs may be a potential prognostic marker
.
The more severe the irAEs, the better the prognosis of patients with multiple systems
.
Timely use of systemic corticosteroids to treat irAEs is the key to ensuring the best long-term prognosis for these patients
.
Studies have shown that in aHCC patients treated with ICI, the appearance of irAEs may be a potential prognostic marker
.
The more severe the irAEs, the better the prognosis of patients with multiple systems
.
Timely use of systemic corticosteroids to treat irAEs is the key to ensuring the best long-term prognosis for these patients
.

Original source:

Original source:

Kennedy Yao Yi Ng, Sze Huey Tan, Jack Jie En Tan, et al.
Impact of Immune-Related Adverse Events on Efficacy of Immune Checkpoint Inhibitors in Patients with Advanced Hepatocellular Carcinoma.
Liver Cancer.
DOI: 10.
1159/000518619

Kennedy Yao Yi Ng, Sze Huey Tan , Jack Jie En Tan, et al Impact of Immune-Related Adverse Events on Efficacy of Immune Checkpoint Inhibitors in Patients with Advanced Hepatocellular Carcinoma Liver Cancer DOI:.
.
.
10.
1159 / 000518619 in this message