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KMID : 1040620200260030328
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Clinical and Molecular Hepatology
2020 Volume.26 No. 3 p.328 ~ p.339
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Effectiveness of nivolumab versus regorafenib in hepatocellular carcinoma patients who failed sorafenib treatment
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Lee Cheol-Hyung
Lee Yun-Bin
Kim Min-Seok
Jang Hee-Joon
Oh Hyun-Woo
Kim Sun-Woong
Cho Eun-Ju
Lee Kyung-Hun
Lee Jeong-Hoon
Yu Su-Jong
Yoon Jung-Hwan
Kim Tae-You
Kim Yoon-Jun
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Abstract
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Background/Aims: Several treatment options are currently available for patients with hepatocellular carcinoma (HCC) failing previous sorafenib treatment. We aimed to compare the effectiveness of regorafenib and nivolumab in these patients.
Methods: Consecutive HCC patients who received regorafenib or nivolumab after failure of sorafenib treatment were included. Primary endpoint was overall survival (OS) and secondary endpoints were time to progression, tumor response rate, and adverse events. Inverse probability of treatment weighting (IPTW) using the propensity score was conducted to reduce treatment selection bias.
Results: Among 150 study patients, 102 patients received regorafenib and 48 patients received nivolumab. Median OS was 6.9 (95% confidence interval [CI], 3.0?10.8) months for regorafenib and 5.9 (95% CI, 3.7?8.1) months for nivolumab (P=0.77 by log-rank test). In multivariable analysis, nivolumab was associated with prolonged OS (vs. regorafenib: adjusted hazard ratio [aHR], 0.54; 95% CI, 0.30?0.96; P=0.04). Time to progression was not significantly different between groups (nivolumab vs. regorafenib: aHR, 0.82; 95% CI, 0.51?1.30; P=0.48). HRs were maintained after IPTW. Objective response rates were 5.9% and 16.7% in patients treated with regorafenib and nivolumab, respectively (P=0.04).
Conclusions: After sorafenib failure, the use of nivolumab may be associated with improved OS and better objective response rate as compared to using regorafenib.
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KEYWORD
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Liver cancer, Regorafenib, Nivolumab, Survival
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