Adjuvant versus Neoadjuvant Immunotherapy for Hepatocellular Carcinoma: Clinical and Immunologic Perspectives

2021 ◽  
Author(s):  
Yung-Yeh Su ◽  
Chia-Chen Li ◽  
Yih-Jyh Lin ◽  
Chiun Hsu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Neoadjuvant Therapy ◽  
Systemic Therapy ◽  
Therapeutic Benefit ◽  
Advanced Hepatocellular Carcinoma ◽  
Curative Therapy ◽  
Trial Conduct ◽  
Neoadjuvant Immunotherapy ◽  
Stage Disease ◽  
Result Analysis

AbstractAdvancement in systemic therapy, particularly immune checkpoint inhibitor (ICI)-based combination regimens, has transformed the treatment landscape for patients with advanced hepatocellular carcinoma (HCC). The advancement in systemic therapy also provides new opportunities of reducing recurrence after curative therapy through adjuvant therapy or improving resectability through neoadjuvant therapy. Improved recurrence-free survival by adjuvant or neoadjuvant ICI-based therapy has been reported in other cancer types. In this article, developments of systemic therapy in adjuvant and neoadjuvant settings for HCC were reviewed. The design of adjuvant and neoadjuvant therapy using ICI-based regimens and potential challenges of trial conduct and result analysis was discussed. Results from these trials may extend the therapeutic benefit of ICI-based systemic therapy beyond the advanced-stage disease and lead to a new era of multidisciplinary management for HCC.

scholarly journals Evolution of systemic therapy of advanced hepatocellular carcinoma

2008 ◽  
Vol 14 (42) ◽  
pp. 6546 ◽  
Author(s):  
Ming Jiang ◽  
Fei Liu ◽  
Wu-Jun Xiong ◽  
Lan Zhong ◽  
Xi-Mei Chen
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systemic Therapy ◽  
Advanced Hepatocellular Carcinoma

TTP or PFS as a surrogate endpoint in advanced hepatocellular carcinoma treated with systemic therapy.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. 4075-4075
Author(s):  
Dae-Won Lee ◽  
Myoung-Jin Jang ◽  
Kyung-Hun Lee ◽  
Tae-Yong Kim ◽  
Sae-Won Han ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systemic Therapy ◽  
Surrogate Endpoint ◽  
Advanced Hepatocellular Carcinoma

Systemic Therapy for Advanced Hepatocellular Carcinoma: Past, Present, and Future

2010 ◽  
Vol 17 (2) ◽  
pp. 120-129 ◽  
Author(s):  
Jennifer L. Giglia ◽  
Scott J. Antonia ◽  
Lawrence B. Berk ◽  
Salvador Bruno ◽  
Sophie Dessureault ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systemic Therapy ◽  
Advanced Hepatocellular Carcinoma

New advances in the diagnosis and management of hepatocellular carcinoma

BMJ ◽  
2020 ◽  
pp. m3544 ◽  
Author(s):  
Ju Dong Yang ◽  
Julie K Heimbach
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systemic Treatment ◽  
Early Stage ◽  
Treatment Options ◽  
Intermediate Stage ◽  
Phase Iii ◽  
Advanced Hepatocellular Carcinoma ◽  
Long Term Outcomes ◽  
Stage Disease

ABSTRACT Hepatocellular carcinoma is one of the leading causes of cancer related death in the world. Biannual surveillance for the disease in patients with cirrhosis and in high risk carriers of hepatitis B virus allows early stage cancer detection and treatment with good long term outcomes. Liver ultrasonography and serum α fetoprotein are the most commonly used surveillance tests. If suspicious results are found on the surveillance test, multiphasic computed tomography or magnetic resonance imaging should be undertaken to confirm the diagnosis of hepatocellular carcinoma. If radiologic tests show inconclusive results, liver biopsy or repeat imaging could be considered for confirmation of hepatocellular carcinoma. Management of the disease is complex. Patients should be evaluated by a multidisciplinary team, and the selection of treatment should consider factors such as tumor burden, severity of liver dysfunction, medical comorbidities, local expertise, and preference of patients. Early stage hepatocellular carcinoma is best managed by curative treatment, which includes resection, ablation, or transplantation. Patients with intermediate stage disease often receive locoregional treatment. Systemic treatment is reserved for patients with advanced disease. Several positive, phase III, randomized controlled trials have expanded the systemic treatment options for advanced hepatocellular carcinoma with promising long term outcomes, especially trials using combination treatments, which could also have eventual implications for the treatment of earlier stage disease.

Treatment patterns and survival in patients with late-stage hepatocellular carcinoma in France: A retrospective database analysis.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 288-288
Author(s):  
Jean-frederic Blanc ◽  
Caroline Laurendeau ◽  
Nadia Kelkouli ◽  
Philippe Mathurin
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systemic Therapy ◽  
Late Stage ◽  
Systemic Treatment ◽  
Best Supportive Care ◽  
Treatment Patterns ◽  
Stage Disease ◽  
Systemic Treatments ◽  
Icd 10

288 Background: The prognosis for patients with late-stage hepatocellular carcinoma (HCC) is poor, with only one systemic treatment option available for patients until 2017. Aim: To describe treatment patterns and survival of French patients following diagnosis of late-stage HCC (Barcelona Clinic Liver Cancer classification B, C or D), using a comprehensive nationwide claims database, SNDS. Methods: The SNDS database was searched from 1 January 2015 to 31 December 2017 for patients with a diagnosis of HCC (ICD-10: C220) and late-stage disease, defined by the identification of transcatheter arterial chemoembolization (TACE) or radioembolization (TARE), HCC systemic therapy and/or best supportive care (BSC). Patients were followed up for a maximum of 2 years. Results: 17,298 patients (mean age: 68.7 years (SD: 11.3), 82.6% male) were identified, with 72.4% diagnosed at late stage. During follow-up, 29.6% of patients were treated with TACE or TARE, and 27.1% received systematic therapy (sorafenib in 99.5% of cases). The median duration of systemic treatment was 7.9 (95% CI: 7.4-8.5) months. In 62.5% of cases, this treatment was discontinued at 12 months; this proportion fell to 40.3% when using mortality as a competitive risk. Survival since diagnosis of late stage HCC differed according to the type of first treatment received. Median overall survival was 23.7, 11.9, 7.4 and 1 month in patients initially receiving TACE, TARE, systemic therapy or no treatment, respectively. Conclusions: These results confirm the high clinical burden of late-stage HCC over this period and the need for second-line systemic treatments to improve patient outcomes.

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