Initial experience of anti-PD1 therapy with nivolumab in advanced hepatocellular carcinoma - PubMed (original) (raw)

Initial experience of anti-PD1 therapy with nivolumab in advanced hepatocellular carcinoma

Duan Feng et al. Oncotarget. 2017.

Abstract

Purpose: To evaluate efficacy and safety of anti-PD1 therapy with nivolumab for treatment of advanced hepatocellular carcinoma (HCC).

Methods: From Jan 2016 to Jan 2017, eleven cases of HCC (average age of 51.8-year), 4 at stage B and 7 at stage C, according to Barcelona Clinic Liver Cancer staging, were treated with nivolumab. There were 4 patients with lung metastasis, 1 with portal vein tumor thrombus, 1 with abdominal metastasis and 1 with bone metastasis. The protocol was nivolumab, 3 mg/kg, on day 1, q3w. All patients were treated for more than 4 cycles. During anti-PD1 treatment period, 6 patients also received sorafenib and 1 patient received cytokine-induced killer cell therapy. Objective response and clinical adverse events were evaluated retrospectively.

Results: Patients underwent a total of 80 cycles of nivolumab therapy, ranging between 4 and 18 cycles per patient. Nivolumab was associated with a disease control rate of 81.8%, with an objective response of 63.6% (Modified Response Evaluation Criteria in Solid Tumors). No adverse effects related to nivolumab were noted.

Conclusion: Our experience shows that nivolumab could achieve acceptable outcome in HCC patients and may serve as an optional treatment, especially for patients who failed to gain a benefit from routine treatments.

Keywords: Immune response; Immunity; Immunology and Microbiology Section; anti-PD1; hepatocellular carcinoma; immunotherapy; nivolumab.

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Conflict of interest statement

CONFLICTS OF INTEREST All authors have declared that no competing interests exist.

Figures

Figure 1

Figure 1. Swimmer plot of 11 patients who received at least 4 cycles of nivolumab

*Patient died.

Figure 2

Figure 2. Radiographies of a 54-year old female patient

PET-CT showed multiple lesions in bilobar, MRI (T2, after 7 cycles with nivolumab) showed lesions significant decreased. MRI (T2, two months after nivolumab was discontinued) showed progressive disease. a. Before nivolumab treatment. b. Seven cycles after nivolumab treatment. c. Two months later after nivolumab withdrawal.

Figure 3

Figure 3. Radiographies of a 43-year old male patient

Tumors in lungs disappeared after 8 cycles of nivolumab. a., c. Pre-treatment. b., d. Post-treatment.

Figure 4

Figure 4. Trend of AFP after nivolumab treatment, in 5 patients who previously had elevated AFP

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