Efficacy and Safety of Durvalumab/Tremelimumab in Unresectable Hepatocellular Carcinoma as Immune Checkpoint Inhibitor Rechallenge Following Atezolizumab/Bevacizumab Treatment

期刊论文
发表日期：

2024年9月2日

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Takuya Sho,
Goki Suda,
Masatsugu Ohara,
Risako Kohya,
Takashi Sasaki,
Sonoe Yoshida,
Shunichi Hosoda,
Koji Ogawa,
Takashi Kitagataya,
Osamu Maehara,
Shunsuke Ohnishi,
Naoki Kawagishi,
Mitsuteru Natsuizaka,
Masato Nakai,
Masaru Baba,
Yoshiya Yamamoto,
Yoko Tsukuda,
Takashi Meguro,
Ren Yamada,
Tomoe Kobayashi,
Tomofumi Takagi,
Naoya Sakamoto

摘要

Background

While guidelines recommend immune checkpoint inhibitor (ICI) rechallenge as second-line therapy for unresectable hepatocellular carcinoma (HCC), data supporting this remain limited, particularly regarding a standard regimen for first- and second-line treatments. Tremelimumab/durvalumab was recently approved but data on ICI rechallenge are lacking.

Objectives

The purpose of this study was to evaluate the early efficacy and safety of tremelimumab/durvalumab for HCC as an ICI rechallenge following initial ICI therapy with atezolizumab/bevacizumab.

Patients and Methods

This multicenter retrospective study included patients with HCC who underwent treatment with tremelimumab/durvalumab, with relevant available clinical information. We evaluated the safety and efficacy of tremelimumab/durvalumab as ICI rechallenge following initial treatment with atezolizumab/bevacizumab. We analyzed the outcomes in patients who underwent tremelimumab/durvalumab as an ICI rechallenge and those who received tremelimumab/durvalumab as their initial ICI therapy

Result

A total of 45 patients treated with tremelimumab/durvalumab were included, with 55.6% (25/45) undergoing ICI rechallenge. The objective-response and disease-control rates in patients who underwent ICI rechallenge were 14.3% (3/21) and 47.6% (10/21), respectively, similar to those in patients initially treated with tremelimumab/durvalumab. All patients (n = 3) who experienced the best response to progressive disease (PD) with initial atezolizumab/bevacizumab experienced PD during ICI rechallenge. The incidence rates of adverse events were similar between patient groups treated with tremelimumab/durvalumab as ICI rechallenge and initial ICI. Among patients experiencing immune-related adverse events (irAEs) with atezolizumab/bevacizumab, 75% (3/4) encountered similar irAEs during ICI rechallenge.

Conclusion

Early safety and efficacy profiles of durvalumab/tremelimumab as ICI rechallenge are satisfactory.

Graphical Abstract