Ipilimumab and nivolumab in advanced hepatocellular carcinoma after failure of prior immune checkpoint inhibitor-based combination therapies: a multicenter retrospective study

J Cancer Res Clin Oncol. 2023 Jul;149(7):3065-3073. doi: 10.1007/s00432-022-04206-8. Epub 2022 Jul 21.

Abstract

Introduction: Immune checkpoint inhibitor (ICI)-based regimens are transforming the landscape of hepatocellular carcinoma (HCC) treatment. We describe the effect of combined ipilimumab and nivolumab in patients with advanced HCC after the failure of prior ICI-based combination treatments.

Methods: The clinical course of patients with advanced HCC who received combined ipilimumab and nivolumab after prior ICI-based combination therapies was assessed. Progression-free survival (PFS), overall response rate (ORR) and disease control rate (DCR) per RECIST v1.1 and mRECIST, overall survival (OS), and safety were analyzed.

Results: Of 109 patients treated with atezolizumab and bevacizumab or other ICI-based combination treatments, ten patients received subsequent therapy with ipilimumab and nivolumab. The majority of patients had Barcelona Clinic Liver Cancer (BCLC) Stage C (80%) HCC and a preserved liver function as defined by Child-Pugh A (80%). At a median follow-up of 15.3 months, ORR for ipilimumab and nivolumab was 30% with a DCR of 40%. Median PFS was 2.9 months and the median OS was 7.4 months.

Conclusion: This retrospective study demonstrates that combined ipilimumab and nivolumab can be effective and tolerable after prior ICI-based combination therapies and provides a rationale for the prospective clinical evaluation of this treatment sequencing.

Keywords: Atezolizumab; Bevacizumab; Hepatocellular carcinoma; Immune checkpoint inhibitors; Ipilimumab; Nivolumab.

Publication types

  • Multicenter Study

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Carcinoma, Hepatocellular* / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects
  • Ipilimumab / adverse effects
  • Liver Neoplasms* / drug therapy
  • Nivolumab / adverse effects
  • Prospective Studies
  • Retrospective Studies

Substances

  • Nivolumab
  • Ipilimumab
  • Immune Checkpoint Inhibitors