Impact of underlying liver disease on unresectable hepatocellular carcinoma treated with immune checkpoint inhibitors.

ABSTRACT:

Background

Immune checkpoint inhibitors (ICIs) are standard therapy for unresectable HCC, but many patients do not respond. Non-viral HCC, particularly non-alcoholic steatohepatitis (NASH), have been implicated in ICI resistance.

Methods

We reviewed 288 patients with unresectable HCC who received ICI from 1/2017 to 12/2021. The overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) between patients with viral HCC and non-viral HCC were compared using the full and Child Pugh (CP) class A only cohorts.

Results

In total, 206 patients (71.5%) had viral HCC (most HCV), and 82 patients had non-viral HCC. Non-viral HCC was associated with worse OS (HR 1.6, 95% CI: 1.1-2.1, P = 0.006) and PFS (HR 1.5, 95% CI: 1.2-2, P = 0.002) in univariate but not multivariate analyses. For the CP class A cohort, non-viral HCC was independently associated with worse OS (HR 1.8, 95% CI: 1.2-2.7, P = 0.005) and PFS (HR 1.9, 95% CI: 1.3-2.7, P < 0.001). Viral HCC and CP class A liver disease was associated with better ORR than non-viral HCC (38% vs. 16%, P = 0.001).

Conclusions

Following ICI treatment, non-viral HCC correlated with worse OS, PFS, and ORR than viral HCC, particularly in patients with preserved liver function.

SUBMITTER: Wu YL 

PROVIDER: S-EPMC11523972 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature