Novel systemic treatment for hepatocellular carcinoma: a step-by-step review of current indications

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the main cause of cancer-related death worldwide. The available treatment options for HCC include liver transplant, locoregional therapy (such as ablation, embolization, and radiotherapy), and systemic treatment. The latter encompasses targeted therapy, immunotherapy, and angiogenesis inhibitors, alone or in combination. The introduction of immune checkpoint inhibitors and targeted drug therapy has been one of the most significant advances in HCC treatment. These therapies were shown to prolong overall survival and progression-free survival in clinical trials including patients with advanced HCC. In recent years, the systemic treatment of advanced HCC has vastly improved, with a median survival of 19.2 months in the IMbrave150 trial. However, further research is needed to determine the optimal sequence of treatment

Novel systemic treatment for hepatocellular carcinoma: a step-by-step review of current indications

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the main cause of cancer-related death worldwide. The available treatment options for HCC include liver transplant, locoregional therapy (such as ablation, embolization, and radiotherapy), and systemic treatment. The latter encompasses targeted therapy, immunotherapy, and angiogenesis inhibitors, alone or in combination. The introduction of immune checkpoint inhibitors and targeted drug therapy has been one of the most significant advances in HCC treatment. These therapies were shown to prolong overall survival and progression-free survival in clinical trials including patients with advanced HCC. In recent years, the systemic treatment of advanced HCC has vastly improved, with a median survival of 19.2 months in the IMbrave150 trial. However, further research is needed to determine the optimal sequence of treatment

Early effects of Nivolumab and Ipilimumab combined immunotherapy in the treatment of metastatic melanoma in Poland : a multicenter experience

Nivolumab and ipilimumab combination became the first-line standard in advanced melanoma. We assessed its efficacy in a real-life study in Poland. In a one-year follow-up, we evaluated the medical records of 50 melanoma patients treated with that modality in five oncology centers. We recorded therapy outcomes and adverse events (AEs) after 3 and 12 months of therapy. At the first checkpoint, the disease control rate (DCR) was recorded in 58% (n = 29) of patients, but the same number of patients (n = 29, 58%) stopped immunotherapy due to disease progression (PD, n = 14, 48.3%), toxicity (n = 11, 37.9%) or death (n = 4, 13.8%). Among patients with DCR after the induction phase, 8 (27.6%) terminated due to toxicity, and 21 (72.4%) continued. However, at the 12-month checkpoint, only 14 patients (27% of all) were still receiving immunotherapy. In 7 (33.3%) it was discontinued due to PD (n = 2), toxicity (n = 2, 28.6% each), or death (n = 3, 42.9%). AEs occurred in 66.7% (n = 34) of patients; severe (grade 3 or 4) in half of them. Interestingly, those with AEs had an 80% lower risk of death (hazard ratio [HR] 0.2, 95% confidence interval [CI] 0.07–0.57, p = 0.001) and PD (HR 0.2, 95%CI 0.09–0.47, p < 0.0001). In the entire group of patients, after a 12-month follow-up, the median overall survival was not reached (NR, range: 6.8 months-NR) and progression-free survival was 6.3 (range: 3-NR) months. Our results demonstrate that combined immunotherapy is less effective in real-life than in pivotal trials. However, early responders will likely continue the therapy after a one-year follow-up. AEs occurrence might be a predictor of clinical effectiveness