Z Gastroenterol 2019; 57(05): e153-e154
DOI: 10.1055/s-0039-1691912
POSTER
Hepatologie
Georg Thieme Verlag KG Stuttgart · New York

PD-1 targeted immunotherapy in advanced hepatocellular carcinoma: efficacy and safety data from an international multicenter real-world cohort

B Scheiner
1   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Vienna, Austria
,
MM Kirstein
2   Hannover Medical School, Department of Gastroenterology, Hepatology and Endocrinology, Hannover, Germany
,
F Hucke
3   Klinikum Klagenfurt am Wörthersee, Department of Gastroenterology and Hepatology, Endocrinology, and Nephrology, Klagenfurt, Austria
,
F Finkelmeier
4   University Hospital Frankfurt, Department of Gastroenterology, Hepatology and Endocrinology, Frankfurt, Germany
,
K Schulze
5   University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
J von Felden
5   University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
S Koch
6   University Medical Center of the Johannes Gutenberg University Mainz, Department of Internal Medicine, Mainz, Germany
,
P Schwabl
1   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Vienna, Austria
,
JB Hinrichs
7   Hannover Medical School, Institute for Radiology, Hannover, Germany
,
F Waneck
8   Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular & Interventional Radiology, Vienna, Austria
,
O Waidmann
9   University Hospital Frankfurt, Department of Gastroenterology, Hepatology and Endocrinology, Frankfurt/Main, Germany
,
T Reiberger
1   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Vienna, Austria
,
C Müller
1   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Vienna, Austria
,
W Sieghart
1   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Vienna, Austria
,
M Trauner
1   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Vienna, Austria
,
A Weinmann
10   University Medical Center of the Johannes Gutenberg University Mainz, Department of Internal Medicine, Main, Germany
,
H Wege
11   University Medical Center Hamburg/Eppendorf, Department of Internal Medicine, Gastroenterology & Hepatology, Hamburg, Germany
,
J Trojan
9   University Hospital Frankfurt, Department of Gastroenterology, Hepatology and Endocrinology, Frankfurt/Main, Germany
,
M Peck-Radosavljevic
12   Klinikum Klagenfurt am Wörthersee, Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology including Centralized Emergency Department (ZAE), Klagenfurt, Austria
,
A Vogel
2   Hannover Medical School, Department of Gastroenterology, Hepatology and Endocrinology, Hannover, Germany
,
M Pinter
1   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Vienna, Austria
› Author Affiliations
Further Information

Publication History

Publication Date:
16 May 2019 (online)

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    Background:

    Programmed cell death protein-1 (PD-1)-targeted immunotherapy has shown promising results in phase II studies of hepatocellular carcinoma (HCC). We report safety and efficacy data of an international, multicenter, real-world cohort of patients with advanced HCC treated with nivolumab or pembrolizumab.

    Methods:

    Sixty-five patients treated with nivolumab (n = 34) or pembrolizumab (n = 31) between July 10, 2015 and December 31, 2018 (data cut-off) across 6 centers in Austria and Germany were retrospectively analyzed.

    Results:

    Child-Pugh class A/B/C was 32 (49%)/28 (43%)/5 (8%). Immunotherapy was used as systemic first-/second-/third-/fourth-line treatment in 9 (14%)/27 (42%)/26 (40%)/3 (5%) patients. Fifty-four patients had at least one follow-up imaging and were therefore available for radiological response assessment. The overall response and disease control rates were 12% and 49%, respectively. Of 52 evaluable patients, four (8%) had hyperprogressive disease. Median time to progression was 5.5 (95%CI, 3.5 – 7.4) months, median progression-free survival was 4.6 (95%CI, 3.0 – 6.2) months, and median overall survival was 11.0 (95%CI, 8.2 – 13.8) months. Most common adverse events were infections (n = 7), rash (n = 6), pruritus (n = 3), fatigue (n = 3), diarrhea (n = 3), and hepatitis (n = 3). Efficacy and safety results were comparable between Child-Pugh A and B patients; however, median OS was shorter in Child-Pugh B patients (16.7 vs. 8.6 months; p = 0.065). There was no difference in terms of efficacy and adverse events between patients who received immunotherapy as first-/second-line and third-/fourth-line, respectively.

    Conclusion:

    PD-1-targeted immunotherapy with nivolumab or pembrolizumab showed promising efficacy and safety in patient with advanced HCC, including subjects with Child-Pugh stage B and patients with intensive pretreatment.


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