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@article{Sharma:2022:10.1002/hep4.1927,
author = {Sharma, R and Pillai, A and Marron, TU and Fessas, P and Saeed, A and Jun, T and Dharmapuri, S and Szafron, D and Naqash, AR and Gampa, A and Wang, Y and Khan, U and Muzaffar, M and Lee, C-J and Lee, P-C and Bulumulle, A and Paul, S and Bettinger, D and Hildebrand, H and Yehia, M and Pressiani, T and Kaseb, A and Huang, Y-H and Ang, C and Kudo, M and Nishida, N and Personeni, N and Rimassa, L and Pinato, DJ},
doi = {10.1002/hep4.1927},
journal = {Hepatology Communications},
pages = {1776--1785},
title = {Patterns and outcomes of subsequent therapy after immune checkpoint inhibitor discontinuation in HCC},
url = {http://dx.doi.org/10.1002/hep4.1927},
volume = {6},
year = {2022}
}

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TY  - JOUR
AB  - The availability of immune checkpoint inhibitors (ICIs) for the management of advanced hepatocellular cancer (HCC) has changed the treatment paradigm. There are emerging questions regarding the efficacy of subsequent anticancer therapies. The primary aim of this retrospective, multicenter study was to examine the types of anticancer treatment received after ICIs and to assess the impact on post-ICI survival. We established an international consortium of 11 tertiary-care referral centers located in the USA (n = 249), Europe (n = 74), and Asia (n = 97), and described patterns of care following ICI therapy. The impact of subsequent therapy on overall survival (OS) was estimated using the Kaplan–Meier method and presented with a 95% confidence interval (CI). A total of 420 patients were treated with ICIs for advanced HCC after one line of systemic therapy (n = 371, 88.8%): 31 (8.8%) had died, 152 (36.2%) received best supportive care (BSC) following ICIs, and 163 patients (38.8%) received subsequent anticancer therapy. Tyrosine kinase inhibitors (TKIs, n = 132, 80.9%), in particular sorafenib (n = 49, 30.0%), were the most common post-ICI therapy followed by external beam radiotherapy (n = 28, 17.2%), further immunotherapy (n = 21, 12.9%), locoregional therapy (n = 23, 14.1%), chemotherapy (n = 9, 5.5%), and surgery (n = 6, 3.6%). Receipt of post-ICI therapy was associated with longer median OS compared with those who had received BSC (12.1 vs. 3.3 months; hazard ratio [HR]: 0.4 (95% CI: 2.7–5.0). No difference in OS was noted in those patients who received TKI before ICIs compared with those who received ICIs followed by TKI. Conclusion: Post-ICI therapy is associated with OS in excess of 12 months, suggesting a role for therapeutic sequencing. OS from TKI therapy was similar to that reported in registration studies, suggesting preserved efficacy following ICIs.
AU  - Sharma,R
AU  - Pillai,A
AU  - Marron,TU
AU  - Fessas,P
AU  - Saeed,A
AU  - Jun,T
AU  - Dharmapuri,S
AU  - Szafron,D
AU  - Naqash,AR
AU  - Gampa,A
AU  - Wang,Y
AU  - Khan,U
AU  - Muzaffar,M
AU  - Lee,C-J
AU  - Lee,P-C
AU  - Bulumulle,A
AU  - Paul,S
AU  - Bettinger,D
AU  - Hildebrand,H
AU  - Yehia,M
AU  - Pressiani,T
AU  - Kaseb,A
AU  - Huang,Y-H
AU  - Ang,C
AU  - Kudo,M
AU  - Nishida,N
AU  - Personeni,N
AU  - Rimassa,L
AU  - Pinato,DJ
DO  - 10.1002/hep4.1927
EP  - 1785
PY  - 2022///
SN  - 2471-254X
SP  - 1776
TI  - Patterns and outcomes of subsequent therapy after immune checkpoint inhibitor discontinuation in HCC
T2  - Hepatology Communications
UR  - http://dx.doi.org/10.1002/hep4.1927
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000788175300001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep4.1927
UR  - http://hdl.handle.net/10044/1/97457
VL  - 6
ER  -

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