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Effectiveness and Safety of Nivolumab in Child–Pugh B Patients with Hepatocellular Carcinoma: A Real-World Cohort Study

Nivolumab has shown durable response and safety in patients with hepatocellular carcinoma (HCC) in previous trials. However, real-world data of nivolumab in HCC patients, especially those with Child–Pugh class B, are limited. To investigate the effectiveness and safety of nivolumab in a real-world c...

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Autores principales: Choi, Won-Mook, Lee, Danbi, Shim, Ju Hyun, Kim, Kang Mo, Lim, Young-Suk, Lee, Han Chu, Yoo, Changhoon, Park, Sook Ryun, Ryu, Min-Hee, Ryoo, Baek-Yeol, Choi, Jonggi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409289/
https://www.ncbi.nlm.nih.gov/pubmed/32698355
http://dx.doi.org/10.3390/cancers12071968
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author Choi, Won-Mook
Lee, Danbi
Shim, Ju Hyun
Kim, Kang Mo
Lim, Young-Suk
Lee, Han Chu
Yoo, Changhoon
Park, Sook Ryun
Ryu, Min-Hee
Ryoo, Baek-Yeol
Choi, Jonggi
author_facet Choi, Won-Mook
Lee, Danbi
Shim, Ju Hyun
Kim, Kang Mo
Lim, Young-Suk
Lee, Han Chu
Yoo, Changhoon
Park, Sook Ryun
Ryu, Min-Hee
Ryoo, Baek-Yeol
Choi, Jonggi
author_sort Choi, Won-Mook
collection PubMed
description Nivolumab has shown durable response and safety in patients with hepatocellular carcinoma (HCC) in previous trials. However, real-world data of nivolumab in HCC patients, especially those with Child–Pugh class B, are limited. To investigate the effectiveness and safety of nivolumab in a real-world cohort of patients with advanced HCC, we retrospectively evaluated 203 patients with HCC who were treated with nivolumab between July 2017 and February 2019. Of 203 patients, 132 patients were classified as Child–Pugh class A and 71 patients were Child–Pugh class B. Objective response rate was lower in patients with Child–Pugh class B than A (2.8% vs. 15.9%; p = 0.010). Child–Pugh class B was an independent negative predictor for objective response. Median overall survival was shorter in Child–Pugh B patients (11.3 vs. 42.9 weeks; adjusted hazard ratio [AHR], 2.10; p < 0.001). In Child–Pugh B patients, overall survival of patients with Child–Pugh score of 8 or 9 was worse than patients with Child–Pugh score of 7 (7.4 vs. 15.3 weeks; AHR, 1.93; p < 0.020). In conclusion, considering the unsatisfactory response in Child–Pugh B patients, nivolumab may not be used in unselected Child–Pugh B patients. Further studies are needed in this patient population.
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spelling pubmed-74092892020-08-25 Effectiveness and Safety of Nivolumab in Child–Pugh B Patients with Hepatocellular Carcinoma: A Real-World Cohort Study Choi, Won-Mook Lee, Danbi Shim, Ju Hyun Kim, Kang Mo Lim, Young-Suk Lee, Han Chu Yoo, Changhoon Park, Sook Ryun Ryu, Min-Hee Ryoo, Baek-Yeol Choi, Jonggi Cancers (Basel) Article Nivolumab has shown durable response and safety in patients with hepatocellular carcinoma (HCC) in previous trials. However, real-world data of nivolumab in HCC patients, especially those with Child–Pugh class B, are limited. To investigate the effectiveness and safety of nivolumab in a real-world cohort of patients with advanced HCC, we retrospectively evaluated 203 patients with HCC who were treated with nivolumab between July 2017 and February 2019. Of 203 patients, 132 patients were classified as Child–Pugh class A and 71 patients were Child–Pugh class B. Objective response rate was lower in patients with Child–Pugh class B than A (2.8% vs. 15.9%; p = 0.010). Child–Pugh class B was an independent negative predictor for objective response. Median overall survival was shorter in Child–Pugh B patients (11.3 vs. 42.9 weeks; adjusted hazard ratio [AHR], 2.10; p < 0.001). In Child–Pugh B patients, overall survival of patients with Child–Pugh score of 8 or 9 was worse than patients with Child–Pugh score of 7 (7.4 vs. 15.3 weeks; AHR, 1.93; p < 0.020). In conclusion, considering the unsatisfactory response in Child–Pugh B patients, nivolumab may not be used in unselected Child–Pugh B patients. Further studies are needed in this patient population. MDPI 2020-07-20 /pmc/articles/PMC7409289/ /pubmed/32698355 http://dx.doi.org/10.3390/cancers12071968 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Choi, Won-Mook
Lee, Danbi
Shim, Ju Hyun
Kim, Kang Mo
Lim, Young-Suk
Lee, Han Chu
Yoo, Changhoon
Park, Sook Ryun
Ryu, Min-Hee
Ryoo, Baek-Yeol
Choi, Jonggi
Effectiveness and Safety of Nivolumab in Child–Pugh B Patients with Hepatocellular Carcinoma: A Real-World Cohort Study
title Effectiveness and Safety of Nivolumab in Child–Pugh B Patients with Hepatocellular Carcinoma: A Real-World Cohort Study
title_full Effectiveness and Safety of Nivolumab in Child–Pugh B Patients with Hepatocellular Carcinoma: A Real-World Cohort Study
title_fullStr Effectiveness and Safety of Nivolumab in Child–Pugh B Patients with Hepatocellular Carcinoma: A Real-World Cohort Study
title_full_unstemmed Effectiveness and Safety of Nivolumab in Child–Pugh B Patients with Hepatocellular Carcinoma: A Real-World Cohort Study
title_short Effectiveness and Safety of Nivolumab in Child–Pugh B Patients with Hepatocellular Carcinoma: A Real-World Cohort Study
title_sort effectiveness and safety of nivolumab in child–pugh b patients with hepatocellular carcinoma: a real-world cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409289/
https://www.ncbi.nlm.nih.gov/pubmed/32698355
http://dx.doi.org/10.3390/cancers12071968
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