The aim of this multicenter study is to compare response obtained by AB o L and identify any factors that may predict the emergence of this response to one of two treatments in a real-world setting.
Study population derived from retrospective analysis of prospectively collected HCC patients (P) treated with AB or L as first-line treatment. ORR with AB vs L was the primary endpoint. The secondary endpoint compared OS with L vs AB in terms of best response.
1312 P were treated with L, and 823 P were treated with AB. ORR was 38.6% for P receiving L, and 27.3% for P receiving AB [p < 0.01; odds ratio (OR) 0.60)]. In responding P (CR + PR), OS was 22.3 months (m) for P receiving L, and 22.5 m for P treated with AB (p 0.20; HR 0.81, reference L). In non-responding P (SD + PD), OS was 10.8 m for P receiving L, and 11.5 m for P receiving AB (p 0.36; HR 0.85, reference L). For P who achieved CR, OS was not reached in both arms, but the result from univariate Cox regression model showed 62% reduction of death risk for P treated with AB (p 0.05). In all multivariate analyses, treatment arm was not found to be an independent factor conditioning OS. Comparing ORR achieved in the two arms, L was shown to be statistically significant in all subgroup P except for Child Pugh B, presence of portal vein thrombosis (PT), αFP ≥ 400 ng/mL, presence of extrahepatic disease (EHD), ALBI 2, and no previous locoregional procedures. P who achieved CR were compared to the rest of the population in the same way. The only statistically significant difference was in favor of L in P with NLR > 3 (p 0.03; OR 0.39). Finally, we evaluated separately which P had more response in AB arm and then in L arm. Only in L arm, three factors favoring response were highlighted: absence of EHD (p < 0.01; OR 1.88), BCLC B (p < 0.01; OR 0.54), absence of PT (p 0.05; OR 1.34), and NLR ≤ 3 (p < 0.01; OR 0.70).
L achieve higher ORR in all P subgroups. P who achieve CR with AB can achieve OS so far never recorded in HCC patients. This study didn’t highlight any factors that could identify HCC P subgroups capable of obtaining CR.
M. Persano.
Has not received any funding.
All authors have declared no conflicts of interest.