Immune checkpoint inhibitors are increasingly used in patients with advanced hepatocellular carcinoma. Most of the current clinical trials evaluating the treatment of ICIs are aimed at patients with Child-Pugh class A liver function, but many patients with advanced HCC have Child-Pugh class B liver function in clinical practice, which leads to a lack of clinical evidence for the use of ICIs in patients with advanced HCC with impaired liver function.
In response to the above problems, the team of Professor Ji Panpu of the Department of Infectious Diseases of the Second Affiliated Hospital of Xi’an Jiaotong University, the team of Dr. Yang Yihui and Ju Dong Yang of Cedars-Sinai Medical Center in Los Angeles, and the team of Professor David J. Pinato, Imperial College London, conducted research. The study systematically analyzed the efficacy and tolerability of ICIs in the treatment of patients with advanced hepatocellular carcinoma with Child-Pugh grade B and 2114 patients with advanced hepatocellular carcinoma with Child-Pugh grade B through a meta-analysis of 22 published studies including a total of 699 patients with advanced hepatocellular carcinoma with Child-Pugh grade B and 2114 patients with Child-Pugh grade A.
The study found that the objective response rate of patients with Child-Pugh grade B advanced hepatocellular carcinoma treated with ICIs was 46%; Median survival was 5.5 months and median progression-free survival was 2.7 months. In patients with advanced hepatocellular carcinoma treated with ICIs, Child-Pugh B had lower ORR and DCR compared to Child-Pugh A. Child-Pugh grade B liver function is independently associated with short overall survival; The adjusted HR is 2.33. In addition, Child-Pugh grade B liver function was also associated with poorer progression-free survival, with an HR of 1.69.
Safety analysis of ICIs in patients with advanced hepatocellular carcinoma with Child-Pugh grade B liver function. (Photo courtesy of the research team)
Overall, this study provides stronger evidence for the use of immunotherapy in patients with advanced hepatocellular carcinoma, but more research is needed to determine the effectiveness of ICIs in this population.
The above research results were published under the title “Immune Checkpoint Inhibitors for Child-Pugh Class B Advanced Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis”, the oncology journal JAMA Oncology, with the Second Affiliated Hospital of Xi’an Jiaotong University as the first author and corresponding authorDr. Yihui Yang and Dr. Bernhard Scheiner are co-first authors. (Source: Yan Tao, China Science News)
Related paper information:https://jamanetwork.com/journals/jamaoncology/fullarticle/2808728
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