Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Cancer Res Commun. 2023 Sep 21;3(9):1912-1916. doi: 10.1158/2767-9764.CRC-23-0025.
Immune checkpoint inhibitors (ICI) can induce atypical tumor responses including pseudoprogression in a subset of patients who may benefit from treatment beyond progression. While ICIs have emerged as frontline treatments for hepatocellular carcinoma (HCC) and are associated with clinical benefit in a minority of patients, it is unclear whether treatment beyond progression has utility in this disease type. In a multicenter cohort analysis, treatment beyond progression was associated with no new safety signals, objective responses in 5.8% of patients, and disease control in 44% of patients. Progression-free survival and overall survival were comparable between patients treated beyond progression and patients treated with subsequent therapies, demonstrating that treatment beyond progression was not detrimental to survival outcomes. Rather, treatment beyond progression may benefit select patients with HCC and could represent a viable strategy for maximizing treatment benefit in these patients.
Treatment beyond progression with ICIs in patients with HCC is safe and may benefit a subset of patients due to later-onset tumor responses or disease stability. These findings may guide the design of trials testing ICIs in HCC and the use of treatment beyond progression in routine practice.
免疫检查点抑制剂（ICI）可在部分患者中引起非典型肿瘤反应，包括假性进展，这些患者可能从进展后治疗中获益。尽管 ICI 已成为肝细胞癌（HCC）的一线治疗方法，并且在少数患者中具有临床获益，但尚不清楚进展后治疗在这种疾病类型中是否有用。在一项多中心队列分析中，进展后治疗与无新的安全信号、5.8%的患者有客观缓解和 44%的患者疾病控制相关。进展后治疗组和接受后续治疗组的无进展生存期和总生存期相当，这表明进展后治疗对生存结果没有不利影响。相反，进展后治疗可能对选择 HCC 患者有益，并且可能是最大限度提高这些患者治疗获益的可行策略。
ICI 在 HCC 患者中的进展后治疗是安全的，并且可能由于迟发性肿瘤反应或疾病稳定性而使部分患者受益。这些发现可能为 HCC 中 ICI 的试验设计和常规实践中进展后治疗的使用提供指导。
