The following is a summary of “Survival outcomes with adjuvant immunotherapy after hepatic resection in patients with intermediate/advanced (BCLC stage B/C) hepatocellular carcinoma: Insights from a propensity-matched multicenter study,” published in the 2024 ASCO Annual Meeting under issue of Oncology by Yang et al.

A rising interest is observed in using adjuvant immunotherapy after liver surgery for hepatocellular carcinoma (HCC), especially in patients with higher risk. 

Researchers conducted a prospective study to determine the effects of adjuvant immunotherapy on long-term recurrence and survival in patients with intermediate/advanced HCC. 

They used a multicenter database to find patients who had curative-intent resection for Barcelona Clinic Liver Cancer (BCLC) stage B/C HCC. Propensity score matching (PSM) was used to compare recurrence-free (RFS) and OS in patients who got adjuvant immune checkpoint inhibitors (ICIs) with those who didn’t. Multivariate Cox regression analysis was used to find predictors of RFS and OS.

The results showed that out of 627 patients, 109 (23.3%) got adjuvant immunotherapy, mainly with mild to moderate side effects. Tislelizumab was most common (51.4%, n=56), sintilimab (29.3%, n=32), camrelizumab (9.2%, n=10), pembrolizumab (6.4%, n=7), and toripalimab (3.7%, n=4). All patients completed at least 3  months of ICI treatment. PSM resulted in 99 matched pairs with comparable baseline characteristics. After matching, those who got immunotherapy had better median RFS (29.6 vs. 19.3 months, P=0.031) and OS (35.1 vs. 27.8 months, P=0.036). Multivariable analysis confirmed immunotherapy as an independent factor for better RFS (HR: 0.630, 95% CI: 0.435-0.914, P=0.015) and OS (HR: 0.601, 95% CI: 0.401-0.898, P=0.013). Subgroup analysis showed benefits in intermediate and advanced HCC.

Investigators concluded that adjuvant immunotherapy boosted RFS and OS in patients with intermediate/advanced HCC after surgery and suggested conducting randomized trials to confirm these benefits in at-risk groups.

Source: meetings.asco.org/abstracts-presentations/234248