Effectiveness of nivolumab versus regorafenib in hepatocellular carcinoma patients who failed sorafenib treatment
이철형, 이윤빈, 김민석, 장희준, 오현우, 김선웅, 조은주, 이경훈, 이정훈, 유수종, 윤정환, 김태유, 김윤준,
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이철형 ( Lee Cheol-Hyung )
Seoul National University College of Medicine Department of Internal Medicine
이윤빈 ( Lee Yun-Bin )
Seoul National University College of Medicine Department of Internal Medicine
김민석 ( Kim Min-Seok )
Seoul National University College of Medicine Department of Internal Medicine
장희준 ( Jang Hee-Joon )
Seoul National University College of Medicine Department of Internal Medicine
오현우 ( Oh Hyun-Woo )
Seoul National University College of Medicine Department of Internal Medicine
김선웅 ( Kim Sun-Woong )
Seoul National University College of Medicine Department of Internal Medicine
조은주 ( Cho Eun-Ju )
Seoul National University College of Medicine Department of Internal Medicine
이경훈 ( Lee Kyung-Hun )
Seoul National University Hospital Department of Internal Medicine
이정훈 ( Lee Jeong-Hoon )
Seoul National University College of Medicine Department of Internal Medicine
유수종 ( Yu Su-Jong )
Seoul National University College of Medicine Department of Internal Medicine
윤정환 ( Yoon Jung-Hwan )
Seoul National University College of Medicine Department of Internal Medicine
김태유 ( Kim Tae-You )
Seoul National University Hospital Department of Internal Medicine
김윤준 ( Kim Yoon-Jun )
Seoul National University College of Medicine Department of Internal Medicine
Abstract
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.
키워드
Liver cancer; Regorafenib; Nivolumab; Survival
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