Radiological response to nivolumab in patients with hepatocellular carcinoma: A multicenter analysis of real-life practice

Autor: Laura Márquez, Christie Perelló, Carmen Ayuso, Bruno Sangro, Maria Varela, Maria Torner Simó, Jordi Bruix, Victor Sapena, Manuel de la Torre-Aláez, José Luis Lledó, Maria Reig, Leonardo G Da Fonseca, Mònica Pons, Jordi Rimola, Ana Matilla, Antonio Guerrero, Ferran Torres, Jose Luis Calleja, Beatriz Minguez
Rok vydání: 2020
Předmět:
Oncology
medicine.medical_specialty
Carcinoma
Hepatocellular
Tomografia computada per emissió de fotó simple
Disease
030218 nuclear medicine & medical imaging
Càncer de fetge
03 medical and health sciences
Tumor Status
Immunitat cel·lular
Magnetic resonance imaging
0302 clinical medicine
Imatges per ressonància magnètica
Internal medicine
Medicine
Humans
Radiology
Nuclear Medicine and imaging
Response Evaluation Criteria in Solid Tumors
Retrospective Studies
Hepatology
medicine.diagnostic_test
business.industry
Liver Neoplasms
Retrospective cohort study
General Medicine
medicine.disease
Hepatologia
Single-photon emission computed tomography
Cellular immunity
Clinical trial
Nivolumab
Treatment Outcome
030220 oncology & carcinogenesis
Radiological weapon
Hepatocellular carcinoma
business
Liver cancer
Zdroj: European journal of radiology. 135
ISSN: 1872-7727
Popis: Background and aims Immune-checkpoint inhibitors are effective in many advanced tumors. However, there is scarce information regarding the radiological response to these agents in hepatocellular carcinoma outside clinical trials. We aimed to describe the radiological response in a retrospective cohort of hepatocellular carcinoma patients treated with nivolumab and to analyze the radiological evolution according to tumor response at first post-treatment radiological assessment. Methods We reviewed pre-treatment and post-treatment images (CT or MRI) obtained at different time-points in patients with hepatocellular carcinoma treated with nivolumab outside clinical trials at seven Spanish centers, assessing the response according to RECIST 1.1 and iRECIST and registering atypical responses. We also analyzed the imaging findings on subsequent assessments according to tumor status on the first posttreatment imaging assessment. Results From the 118 patients with hepatocellular carcinoma treated with nivolumab, we finally analyzed data from 31 patients (71 % Child-Pugh A; 74 % BCLC-C). Median follow-up was 8.39 months [IQR 5.00–10.92]; median overall survival was 12.82 months (95 %CI 10.92–34.79). According to RECIST 1.1, the objective response rate was 16 % and according to iRECIST, the objective response rate was 22.6 %. Findings at the first post-treatment assessment varied, showing stable disease in 44.8 % of patients; findings during follow-up also varied widely, including 4 hyperprogressions and 3 pseudoprogressions. Conclusion Imaging findings during nivolumab treatment are heterogeneous between and within patients. Progression of disease does not always signify treatment failure, and surrogate end-points may not reflect survival outcomes, making the management of hepatocellular carcinoma patients under immunotherapy challenging.
Databáze: OpenAIRE
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