Acta Clinica Belgica,
Journal Year:
2025,
Volume and Issue:
unknown, P. 1 - 7
Published: Jan. 15, 2025
The
incidence
of
hepatocellular
carcinoma
(HCC)
is
rising,
with
a
shift
towards
Metabolic
Dysfunction-associated
Steatotic
Liver
Disease
becoming
the
dominant
risk
factor
in
Western
countries.
Significant
advances
treatment
have
broadened
range
available
therapeutic
options.
For
this
reason,
clinical
decision-making,
along
multidisciplinary
team
approach,
plays
crucial
role
improving
patient
outcomes.
Following
several
landmark
trials,
immune
checkpoint
inhibitor-based
therapy
has
now
become
established
first-line
standard
care
for
advanced
HCC.
Additionally,
application
immunotherapy
shifting
to
include
patients
earlier
stages
Research
on
combination
locoregional
therapies
intermediate-stage
HCC
recently
reported
positive
results,
and
other
phase
III
trials
same
population
early-stage
are
currently
progress.
Furthermore,
growing
number
reports
support
safety
efficacy
immunotherapeutic
agents
as
potential
adjuncts
downstaging
HCC,
thus
facilitating
successful
liver
transplantation.
We
will
discuss
published
ongoing
expanding
field
different
PLoS ONE,
Journal Year:
2024,
Volume and Issue:
19(9), P. e0311084 - e0311084
Published: Sept. 25, 2024
Durvalumab
plus
tremelimumab
(Durva/Treme)
combined
immunotherapy
is
the
first-line
therapy
recommended
for
unresectable
hepatocellular
carcinoma
(HCC).
Since
sequential
more
effective
in
improving
prognosis,
tumor
markers
have
been
used
as
predictive
biomarkers
response
to
systemic
therapy.
This
study
aimed
investigate
ability
of
objective
(OR)
by
Durva/Treme
against
HCC.
In
this
multicenter
study,
110
patients
with
HCC
who
received
were
retrospectively
enrolled.
The
OR
rate
was
15.5%.
To
aid
early
decision-making
regarding
OR,
we
evaluated
predictors
contributing
two
steps:
before
(first
step)
and
4
weeks
after
(second
treatment
induction.
Changes
(alpha-fetoprotein
[AFP]
des-gamma-carboxy
prothrombin
[DCP])
from
baseline
(ΔAFP/ΔDCP)
included
input
factors.
first
step,
multivariable
analysis
identified
only
AFP
level
(odds
ratio
3.497,
p
=
0.029)
a
predictor
OR.
Patients
≥
400
ng/mL
had
significantly
higher
than
those
<
(28.2
vs.
8.5%,
0.011),
there
no
significant
difference
progression-free
survival
(PFS)
between
groups.
When
AFP/DCP
defined
≥10%
reduction
baseline,
showed
that
6.023,
0.042)
DCP
11.657,
0.006)
both
independent
second
step.
PFS
or
longer
without
response.
demonstrated
use
can
predict
receiving
Current Oncology,
Journal Year:
2023,
Volume and Issue:
30(10), P. 8774 - 8792
Published: Sept. 26, 2023
Hepatocellular
carcinoma
(HCC)
represents
the
most
common
primary
liver
cancer
and
is
considered
a
major
global
health
problem
as
one
of
leading
causes
cancer-related
death
in
world.
Due
to
increase
life
expectancy
epidemiological
growth
specific
risk
factors,
such
metabolic
dysfunction-associated
steatotic
disease
(MASLD),
incidence
HCC
growing
globally,
mortality
rates
are
still
high.
Moreover,
patients
frequently
present
at
an
intermediate
or
advanced
tumor
stage,
when
curative
treatments,
surgical
resection,
transplantation
ablation
no
longer
applicable.
In
these
cases,
trans-arterial
chemoembolization
(TACE),
radioembolization
(TARE),
systemic
therapy
only
suitable
options
achieve
control.
The
multi-kinase
inhibitor
Sorafenib
has
been
treatment
available
for
unresectable
almost
decade,
but
last
couple
years
new
therapeutic
have
emerged.
Recent
advances
understanding
interactions
between
its
microenvironment,
especially
immune
escape,
led
advent
immunotherapy.
Currently,
first-line
represented
by
combination
checkpoint
(ICI)
Atezolizumab
plus
Bevacizumab,
anti-vascular
endothelial
factor
(VEGF)
monoclonal
antibody,
many
other
ICIs
investigated,
Nivolumab,
Pembrolizumab,
Durvalumab
Ipilimumab.
However,
second-
third-line
therapies,
correct
sequence
treatments
remains
open
not
addressed
studies.
This
explains
urge
find
that
can
improve
survival
quality
go
beyond
first
line
treatment.
aim
this
paper
offer
complete
overview
recent
innovations
locally
metastatic
HCC,
including
emerging
with
particular
focus
on
sequences.
we
will
provide
outlook
possible
future
approaches
who
progress
therapies.
Hepatology,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Nov. 21, 2024
Background
and
Aims:
The
outcome
of
patients
with
HCC
who
achieved
complete
response
(CR)
to
immune-checkpoint
inhibitor
(ICI)–based
systemic
therapies
is
unclear.
Approach
Results:
Retrospective
study
had
CR
according
modified
Response
Evaluation
Criteria
in
Solid
Tumors
(CR-mRECIST)
ICI-based
from
28
centers
Asia,
Europe,
the
United
States.
Of
3933
treated
noncurative
therapies,
174
(4.4%)
CR-mRECIST,
97
(2.5%)
RECISTv1.1
(CR-RECISTv1.1)
as
well.
mean
age
total
cohort
(male,
85%;
Barcelona-Clinic
Liver
Cancer-C,
70%)
was
65.9±9.8
years.
majority
(83%)
received
combination
therapies.
Median
follow-up
32.2
(95%
CI:
29.9–34.4)
months.
One-
3-year
overall
survival
rates
were
98%
86%.
recurrence-free
excellent
CR-mRECIST-only
CR-RECISTv1.1
(78%
55%;
70%
42%).
Among
discontinued
ICIs
for
reasons
other
than
recurrence,
those
immunotherapy
≥6
months
after
first
mRECIST
a
longer
earlier
(
p
=0.008).
9
underwent
curative
surgical
conversion
therapy,
8
(89%)
pathological
(CR-RECISTv1.1,
n=
2/2;
CR-mRECIST-only,
6/7).
Conclusions:
Overall
excellent,
6
7
therapy
CR.
Despite
potential
limitations,
these
findings
support
use
context
clinical
decision-making.
When
considering
ICI
discontinuation,
treatment
at
least
beyond
seems
advisable.
Future Oncology,
Journal Year:
2025,
Volume and Issue:
21(3), P. 313 - 319
Published: Jan. 15, 2025
Given
treatment
landscape
changes,
understanding
the
prevalence
of
medical
conditions/comorbidities
influencing
real-world
unresectable
hepatocellular
carcinoma
(uHCC)
decisions
is
key
for
improving
outcomes.
In
a
retrospective
chart
review,
physicians
abstracted
data
from
uHCC
patients
initiating
first-line
(1L)
between
June
2020
and
April
2022.
Frequencies
at
1L
initiation
were
reported.
Among
433
patients,
77%
had
Barcelona
Cancer
Liver
Clinic
(BCLC)-C
37%
Child-Pugh
B
status.
Overall,
51%
≥
1
condition/comorbidity
making
them
potentially
less
suitable
immunotherapy
combination
regimen
(e.g.
atezolizumab
plus
bevacizumab),
including
upper/lower
gastrointestinal
bleeding
risk
(38%),
chronic
kidney
disease
(15%),
history
thromboembolic
events
(12%),
autoimmune
disorders
(5%).
More
than
half
combination.
This
study
provides
timely
insight
into
how
combinations
are
being
used
in
setting
among
large
number
patients.
Acta Clinica Belgica,
Journal Year:
2025,
Volume and Issue:
unknown, P. 1 - 7
Published: Jan. 15, 2025
The
incidence
of
hepatocellular
carcinoma
(HCC)
is
rising,
with
a
shift
towards
Metabolic
Dysfunction-associated
Steatotic
Liver
Disease
becoming
the
dominant
risk
factor
in
Western
countries.
Significant
advances
treatment
have
broadened
range
available
therapeutic
options.
For
this
reason,
clinical
decision-making,
along
multidisciplinary
team
approach,
plays
crucial
role
improving
patient
outcomes.
Following
several
landmark
trials,
immune
checkpoint
inhibitor-based
therapy
has
now
become
established
first-line
standard
care
for
advanced
HCC.
Additionally,
application
immunotherapy
shifting
to
include
patients
earlier
stages
Research
on
combination
locoregional
therapies
intermediate-stage
HCC
recently
reported
positive
results,
and
other
phase
III
trials
same
population
early-stage
are
currently
progress.
Furthermore,
growing
number
reports
support
safety
efficacy
immunotherapeutic
agents
as
potential
adjuncts
downstaging
HCC,
thus
facilitating
successful
liver
transplantation.
We
will
discuss
published
ongoing
expanding
field
different
