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Outcomes Similar for Neoadjuvant ICI-Based Therapy, Upfront Surgery for Liver Cancer

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Rates of margin-negative resection and recurrence-free survival similar for neoadjuvant immunotherapy, surgery patients

By Elana Gotkine HealthDay Reporter

THURSDAY, Aug. 22, 2024 (HealthDay News) — Patients treated with neoadjuvant immune checkpoint inhibitor (ICI)-based therapy for hepatocellular carcinoma (HCC) have higher-risk disease features but achieve outcomes comparable to those undergoing upfront surgery, according to a study published online Aug. 15 in Cancer Research Communications.

Mari Nakazawa, M.D., from the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center in Baltimore, and colleagues retrospectively examined the outcomes of patients who underwent surgical resection for HCC and compared clinical outcomes for patients who received neoadjuvant immunotherapy versus those who underwent upfront resection. A total of 92 patients were included; 36 received neoadjuvant ICI-based treatment.

The researchers found that 61.1 percent of the patients who received neoadjuvant ICI-based therapy were outside of standard resectability criteria and were more likely to have features linked to risk for disease recurrence. The rates of margin-negative resection and recurrence-free survival (RFS) were similar for patients who received neoadjuvant immunotherapy and those who underwent upfront surgical resection (median RFS, 44.8 versus 49.3 months). For patients with a pathologic response, a nonsignificant trend toward superior RFS was seen with neoadjuvant therapy.

“Our observations highlight the need for future prospective trials to further define the role of neoadjuvant ICI therapy in both traditionally resectable and high-risk localized HCC populations,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

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