TKIs beyond immunotherapy predict improved survival in advanced HCC.

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Citation: Journal of Cancer Research & Clinical Oncology. 149(6):2559-2574, 2023 Jun.PMID: 35773429Institution: MedStar Georgetown University Hospital/MedStar Washington Hospital CenterDepartment: Internal Medicine ResidencyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Carcinoma, Hepatocellular | *Carcinoma, Non-Small-Cell Lung | *Liver Neoplasms | *Lung Neoplasms | Carcinoma, Hepatocellular/dt [Drug Therapy] | Carcinoma, Non-Small-Cell Lung/pa [Pathology] | Humans | Immunotherapy/mt [Methods] | Liver Neoplasms/dt [Drug Therapy] | Lung Neoplasms/pa [Pathology] | Protein Kinase Inhibitors/ae [Adverse Effects] | Retrospective Studies | Year: 2023ISSN:
  • 0171-5216
Name of journal: Journal of cancer research and clinical oncologyAbstract: CONCLUSION: We show that disease control predicts prolonged mOS and mPFS. Furthermore, TKI therapy administered after immunotherapy predicts prolonged mOS in patients with advanced HCC. Copyright � 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.METHODS: We retrospectively studied 77 patients with advanced HCC receiving immunotherapy. Patient characteristics and outcomes were assessed using various statistical methods, including the log-rank test and Kaplan-Meier methods. Cox proportional hazard modeling was used for multivariable survival analysis.PURPOSE: For patients with advanced HCC, predictors of immunotherapy response are scarce, and the benefits of tyrosine kinase inhibitor (TKI) treatment after immunotherapy are unclear. We explored whether clinical features, such as target lesion response, immune-mediated toxicity, or subsequent TKI therapy predict immunotherapy response.RESULTS: For all patients, median overall survival (mOS) was 13 months (95% CI 8-19), and median progression-free survival (mPFS) was 6 months (95% CI 4-10). Patients with partial response (PR) and stable disease (SD) compared to progressive disease (PD) had prolonged mPFS (27 vs. 5 vs. 1 month(s), p < 0.0001) and mOS (not met vs. 11 vs. 3 months, p < 0.0001). Patients with vs. without immune-mediated toxicities trended towards longer mPFS (9 vs. 4 months p = 0.133) and mOS (17 vs. 9 months; p = 0.095). Patients who did vs. did not receive a tyrosine kinase inhibitor (TKI) after immunotherapy had a significantly improved mOS (19 vs. 5 months, p = 0.0024)). Based on multivariate modeling, the hazard ratio (HR) of overall survival (OS) of patients receiving TKI vs. no TKI was 0.412 (p = 0.0043).All authors: Armstrong S, Geng X, Hartley ML, He AR, Jha RC, Kulasekaran M, Prins P, Roy T, Shaukat F, Singh B, Wang HOriginally published: Journal of Cancer Research & Clinical Oncology. 2022 Jun 30Original year of publication: 2022Fiscal year: FY2023Fiscal year of original publication: | FY2022 | | Original title: TKIs beyond immunotherapy predict improved survival in advanced HCC.Digital Object Identifier: Date added to catalog: | 2022-09-26
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CONCLUSION: We show that disease control predicts prolonged mOS and mPFS. Furthermore, TKI therapy administered after immunotherapy predicts prolonged mOS in patients with advanced HCC. Copyright � 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

METHODS: We retrospectively studied 77 patients with advanced HCC receiving immunotherapy. Patient characteristics and outcomes were assessed using various statistical methods, including the log-rank test and Kaplan-Meier methods. Cox proportional hazard modeling was used for multivariable survival analysis.

PURPOSE: For patients with advanced HCC, predictors of immunotherapy response are scarce, and the benefits of tyrosine kinase inhibitor (TKI) treatment after immunotherapy are unclear. We explored whether clinical features, such as target lesion response, immune-mediated toxicity, or subsequent TKI therapy predict immunotherapy response.

RESULTS: For all patients, median overall survival (mOS) was 13 months (95% CI 8-19), and median progression-free survival (mPFS) was 6 months (95% CI 4-10). Patients with partial response (PR) and stable disease (SD) compared to progressive disease (PD) had prolonged mPFS (27 vs. 5 vs. 1 month(s), p < 0.0001) and mOS (not met vs. 11 vs. 3 months, p < 0.0001). Patients with vs. without immune-mediated toxicities trended towards longer mPFS (9 vs. 4 months p = 0.133) and mOS (17 vs. 9 months; p = 0.095). Patients who did vs. did not receive a tyrosine kinase inhibitor (TKI) after immunotherapy had a significantly improved mOS (19 vs. 5 months, p = 0.0024)). Based on multivariate modeling, the hazard ratio (HR) of overall survival (OS) of patients receiving TKI vs. no TKI was 0.412 (p = 0.0043).

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