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This article is from NEJM Journal Watch
A New Treatment Option for Unresectable Hepatocellular Carcinoma
New treatment options for unresectable hepatocellular carcinoma
Review by David H.
Combination therapy with anti-CTLA-4 and anti-PD-L1 drugs prolonged survival compared with sorafenib
The new standard first-line treatment for advanced hepatocellular carcinoma is bevacizumab plus atezolizumab, which replaces previous first-line treatment with sorafenib or lenvatinib
In a global, industry-funded, open-label phase 3 trial, patients with advanced Child-Pugh grade A hepatocellular carcinoma were randomized into three groups: sorafenib, the anti-PD-L1 drug durvalumab Or a single dose of the anti-CTLA-4 drug tremelimumab combined with subsequent durvalumab
Of 1,171 patients: 31% had previous hepatitis B, 27% had hepatitis C; 53% had extrahepatic tumor spread; 35% had AFP elevations to ≥400 ng/mL; 39% had PD-L1 tumors or Immune cells were positive
At a median follow-up of 33 months, OS was higher in the tremelimumab/durvalumab group than in the sorafenib group (median, 16.
Comment
A single dose of tremelimumab combined with subsequent durvalumab provides a new treatment option for patients with advanced hepatocellular carcinoma with a 3-year overall survival rate of 30%
Reviewed article
Abou-Alfa GK et al.
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