Outcomes of Post-Immunotherapy Durable Responders of Advanced Hepatocellular Carcinoma- with Emphasis on Locoregional Therapy for Oligoprogression

Tsung Hao Liu; San Chi Chen; Kun Ming Rau; Li Chun Lu; Po Ting Lin; Yung Yeh Su; Wei Teng; Shiue Wei Lai; Ren Hua Yeh; Tsui Mai Kao; Pei Chang Lee; Chi Jung Wu; Chien Hung Chen; Chih Hung Hsu; Shi Ming Lin; Yi Hsiang Huang; Li Tzong Chen; Ann Lii Cheng; Ying Chun Shen

doi:10.1159/000536549

Outcomes of Post-Immunotherapy Durable Responders of Advanced Hepatocellular Carcinoma- with Emphasis on Locoregional Therapy for Oligoprogression

Tsung Hao Liu, San Chi Chen, Kun Ming Rau, Li Chun Lu, Po Ting Lin, Yung Yeh Su, Wei Teng, Shiue Wei Lai, Ren Hua Yeh, Tsui Mai Kao, Pei Chang Lee, Chi Jung Wu, Chien Hung Chen, Chih Hung Hsu, Shi Ming Lin, Yi Hsiang Huang, Li Tzong Chen, Ann Lii Cheng, Ying Chun Shen^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: The progression patterns, dispositions, and outcomes of patients with advanced hepatocellular carcinoma (HCC) who achieved durable responses with immunotherapy remain poorly characterized. Methods: Patients with advanced HCC who received immune checkpoint inhibitor (ICI)-based immunotherapy and achieved durable responses were retrospectively included. A durable response was defined as partial response (PR) or stable disease (SD) per RECIST 1.1 for more than 8 months after initiation of immunotherapy. Oligoprogression and polyprogression were defined as progression at ≥3 and <3 lesions, respectively. Results: A total of 91 durable responders (63 PR and 28 SD) were identified. The majority had chronic viral hepatitis (n = 69, 75.8%). Forty-seven (51.6%) and 44 (48.4%) patients received the index immunotherapy as first-line and second- or beyond-line therapy, respectively. Fifty-four (59.3%) patients subsequently developed progression, with a predominant pattern of oligoprogression (66.7%). The median overall survival (OS) was 46.2 months (95% CI: 34.1 58.3). For patients with subsequent progression, employment of locoregional therapy (LRT) for progression was associated with prolonged OS (univariate analysis: hazard ratio [HR] 0.397, p = 0.009; multivariate analysis: HR 0.363, p = 0.050). Patients with oligoprogression who received LRT showed longer median OS than those who did not (48.4 vs. 20.5 months, p > 0.001). In contrast, the median OS of patients with polyprogression who received LRT was not different from those without LRT (27.7 vs. 25.5 months, p = 0.794). Conclusion: Approximately 60% of the post-immunotherapy durable responders of HCC subsequently develop progression. Proactive LRT may further rescue patients who develop subsequent oligoprogression. Prospective studies are mandatory to clarify the proper management of durable responders with subsequent progression.

Original language	English
Pages (from-to)	509-521
Number of pages	13
Journal	Liver Cancer
Volume	13
Issue number	5
DOIs	https://doi.org/10.1159/000536549
State	Published - 1 Feb 2024

Keywords

Durable response
Hepatocellular carcinoma
Immunotherapy
Locoregional therapy
Oligoprogression

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1159/000536549

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Liu, T. H., Chen, S. C., Rau, K. M., Lu, L. C., Lin, P. T., Su, Y. Y., Teng, W., Lai, S. W., Yeh, R. H., Kao, T. M., Lee, P. C., Wu, C. J., Chen, C. H., Hsu, C. H., Lin, S. M., Huang, Y. H., Chen, L. T., Cheng, A. L., & Shen, Y. C. (2024). Outcomes of Post-Immunotherapy Durable Responders of Advanced Hepatocellular Carcinoma- with Emphasis on Locoregional Therapy for Oligoprogression. Liver Cancer, 13(5), 509-521. https://doi.org/10.1159/000536549

@article{bdba55e33b8b4a8998e8a79e71e00de3,

title = "Outcomes of Post-Immunotherapy Durable Responders of Advanced Hepatocellular Carcinoma- with Emphasis on Locoregional Therapy for Oligoprogression",

abstract = "Introduction: The progression patterns, dispositions, and outcomes of patients with advanced hepatocellular carcinoma (HCC) who achieved durable responses with immunotherapy remain poorly characterized. Methods: Patients with advanced HCC who received immune checkpoint inhibitor (ICI)-based immunotherapy and achieved durable responses were retrospectively included. A durable response was defined as partial response (PR) or stable disease (SD) per RECIST 1.1 for more than 8 months after initiation of immunotherapy. Oligoprogression and polyprogression were defined as progression at ≥3 and <3 lesions, respectively. Results: A total of 91 durable responders (63 PR and 28 SD) were identified. The majority had chronic viral hepatitis (n = 69, 75.8%). Forty-seven (51.6%) and 44 (48.4%) patients received the index immunotherapy as first-line and second- or beyond-line therapy, respectively. Fifty-four (59.3%) patients subsequently developed progression, with a predominant pattern of oligoprogression (66.7%). The median overall survival (OS) was 46.2 months (95% CI: 34.1 58.3). For patients with subsequent progression, employment of locoregional therapy (LRT) for progression was associated with prolonged OS (univariate analysis: hazard ratio [HR] 0.397, p = 0.009; multivariate analysis: HR 0.363, p = 0.050). Patients with oligoprogression who received LRT showed longer median OS than those who did not (48.4 vs. 20.5 months, p > 0.001). In contrast, the median OS of patients with polyprogression who received LRT was not different from those without LRT (27.7 vs. 25.5 months, p = 0.794). Conclusion: Approximately 60% of the post-immunotherapy durable responders of HCC subsequently develop progression. Proactive LRT may further rescue patients who develop subsequent oligoprogression. Prospective studies are mandatory to clarify the proper management of durable responders with subsequent progression.",

keywords = "Durable response, Hepatocellular carcinoma, Immunotherapy, Locoregional therapy, Oligoprogression",

author = "Liu, {Tsung Hao} and Chen, {San Chi} and Rau, {Kun Ming} and Lu, {Li Chun} and Lin, {Po Ting} and Su, {Yung Yeh} and Wei Teng and Lai, {Shiue Wei} and Yeh, {Ren Hua} and Kao, {Tsui Mai} and Lee, {Pei Chang} and Wu, {Chi Jung} and Chen, {Chien Hung} and Hsu, {Chih Hung} and Lin, {Shi Ming} and Huang, {Yi Hsiang} and Chen, {Li Tzong} and Cheng, {Ann Lii} and Shen, {Ying Chun}",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s). Published by S. Karger AG, Basel.",

year = "2024",

month = feb,

day = "1",

doi = "10.1159/000536549",

language = "English",

volume = "13",

pages = "509--521",

journal = "Liver Cancer",

issn = "2235-1795",

publisher = "S. Karger AG",

number = "5",

}

Liu, TH, Chen, SC, Rau, KM, Lu, LC, Lin, PT, Su, YY, Teng, W, Lai, SW, Yeh, RH, Kao, TM, Lee, PC, Wu, CJ, Chen, CH, Hsu, CH, Lin, SM, Huang, YH, Chen, LT, Cheng, AL & Shen, YC 2024, 'Outcomes of Post-Immunotherapy Durable Responders of Advanced Hepatocellular Carcinoma- with Emphasis on Locoregional Therapy for Oligoprogression', Liver Cancer, vol. 13, no. 5, pp. 509-521. https://doi.org/10.1159/000536549

TY - JOUR

T1 - Outcomes of Post-Immunotherapy Durable Responders of Advanced Hepatocellular Carcinoma- with Emphasis on Locoregional Therapy for Oligoprogression

AU - Liu, Tsung Hao

AU - Chen, San Chi

AU - Rau, Kun Ming

AU - Lu, Li Chun

AU - Lin, Po Ting

AU - Su, Yung Yeh

AU - Teng, Wei

AU - Lai, Shiue Wei

AU - Yeh, Ren Hua

AU - Kao, Tsui Mai

AU - Lee, Pei Chang

AU - Wu, Chi Jung

AU - Chen, Chien Hung

AU - Hsu, Chih Hung

AU - Lin, Shi Ming

AU - Huang, Yi Hsiang

AU - Chen, Li Tzong

AU - Cheng, Ann Lii

AU - Shen, Ying Chun

PY - 2024/2/1

Y1 - 2024/2/1

N2 - Introduction: The progression patterns, dispositions, and outcomes of patients with advanced hepatocellular carcinoma (HCC) who achieved durable responses with immunotherapy remain poorly characterized. Methods: Patients with advanced HCC who received immune checkpoint inhibitor (ICI)-based immunotherapy and achieved durable responses were retrospectively included. A durable response was defined as partial response (PR) or stable disease (SD) per RECIST 1.1 for more than 8 months after initiation of immunotherapy. Oligoprogression and polyprogression were defined as progression at ≥3 and <3 lesions, respectively. Results: A total of 91 durable responders (63 PR and 28 SD) were identified. The majority had chronic viral hepatitis (n = 69, 75.8%). Forty-seven (51.6%) and 44 (48.4%) patients received the index immunotherapy as first-line and second- or beyond-line therapy, respectively. Fifty-four (59.3%) patients subsequently developed progression, with a predominant pattern of oligoprogression (66.7%). The median overall survival (OS) was 46.2 months (95% CI: 34.1 58.3). For patients with subsequent progression, employment of locoregional therapy (LRT) for progression was associated with prolonged OS (univariate analysis: hazard ratio [HR] 0.397, p = 0.009; multivariate analysis: HR 0.363, p = 0.050). Patients with oligoprogression who received LRT showed longer median OS than those who did not (48.4 vs. 20.5 months, p > 0.001). In contrast, the median OS of patients with polyprogression who received LRT was not different from those without LRT (27.7 vs. 25.5 months, p = 0.794). Conclusion: Approximately 60% of the post-immunotherapy durable responders of HCC subsequently develop progression. Proactive LRT may further rescue patients who develop subsequent oligoprogression. Prospective studies are mandatory to clarify the proper management of durable responders with subsequent progression.

AB - Introduction: The progression patterns, dispositions, and outcomes of patients with advanced hepatocellular carcinoma (HCC) who achieved durable responses with immunotherapy remain poorly characterized. Methods: Patients with advanced HCC who received immune checkpoint inhibitor (ICI)-based immunotherapy and achieved durable responses were retrospectively included. A durable response was defined as partial response (PR) or stable disease (SD) per RECIST 1.1 for more than 8 months after initiation of immunotherapy. Oligoprogression and polyprogression were defined as progression at ≥3 and <3 lesions, respectively. Results: A total of 91 durable responders (63 PR and 28 SD) were identified. The majority had chronic viral hepatitis (n = 69, 75.8%). Forty-seven (51.6%) and 44 (48.4%) patients received the index immunotherapy as first-line and second- or beyond-line therapy, respectively. Fifty-four (59.3%) patients subsequently developed progression, with a predominant pattern of oligoprogression (66.7%). The median overall survival (OS) was 46.2 months (95% CI: 34.1 58.3). For patients with subsequent progression, employment of locoregional therapy (LRT) for progression was associated with prolonged OS (univariate analysis: hazard ratio [HR] 0.397, p = 0.009; multivariate analysis: HR 0.363, p = 0.050). Patients with oligoprogression who received LRT showed longer median OS than those who did not (48.4 vs. 20.5 months, p > 0.001). In contrast, the median OS of patients with polyprogression who received LRT was not different from those without LRT (27.7 vs. 25.5 months, p = 0.794). Conclusion: Approximately 60% of the post-immunotherapy durable responders of HCC subsequently develop progression. Proactive LRT may further rescue patients who develop subsequent oligoprogression. Prospective studies are mandatory to clarify the proper management of durable responders with subsequent progression.

KW - Durable response

KW - Hepatocellular carcinoma

KW - Immunotherapy

KW - Locoregional therapy

KW - Oligoprogression

UR - http://www.scopus.com/inward/record.url?scp=85194701732&partnerID=8YFLogxK

U2 - 10.1159/000536549

DO - 10.1159/000536549

M3 - Article

AN - SCOPUS:85194701732

SN - 2235-1795

VL - 13

SP - 509

EP - 521

JO - Liver Cancer

JF - Liver Cancer

IS - 5

ER -

Outcomes of Post-Immunotherapy Durable Responders of Advanced Hepatocellular Carcinoma- with Emphasis on Locoregional Therapy for Oligoprogression

Abstract

Keywords

UN SDGs

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