| Institution: | 1. Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, 12th Floor, New York, NY, 10029;2. Recanti/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, New York;3. Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, New York;1. Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers (location VUmc), De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands;2. Department of Surgical Oncology, Amsterdam University Medical Centers (location VUmc), De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands;3. Department of Diagnostic and Interventional Radiology, Humanitas Research Hospital, Rozzano, Milan, Italy;1. Department of Pediatric Radiology, Division of Interventional Radiology, Akron Children’s Hospital, One Perkins Square, Akron, OH 44308;2. Department of Radiology, Cleveland Clinic Akron General Hospital, Akron, Ohio;3. Department of Radiology, Case Western Reserve University MetroHealth Medical Center, Cleveland, Ohio;4. Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;1. Department of Radiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan;2. Department of Gastroenterology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan;1. Department of Medical Imaging, Prince of Wales Hospital, 320-346 Barker St, Randwick NSW 2031, Australia;2. Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia;3. South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia;4. Department of Trauma, Liverpool Hospital, Sydney, New South Wales, Australia;5. Department of Radiology, Liverpool Hospital, Sydney, New South Wales, Australia;6. Department of Vascular Surgery, Liverpool Hospital, Sydney, New South Wales, Australia;7. Department of Interventional Radiology, Liverpool Hospital, Sydney, New South Wales, Australia |
| Abstract: | PurposeTo assess the safety of locoregional treatment (LRT) combined with nivolumab for intermediate and advanced hepatocellular carcinoma (HCC).Materials and MethodsA single-center retrospective review included 29 patients undergoing 41 LRTs—transarterial chemoembolization or yttrium-90 transarterial radioembolization—60 days before or concurrently with nivolumab. Demographic, clinical, and laboratory values and adverse events were reviewed before and after nivolumab initiation and after each LRT. Treatment response and time to progression were assessed using Modified Response Evaluation Criteria in Solid Tumors. Clinical events, including nivolumab termination, death, and time of last follow-up, were assessed.ResultsOver a median nivolumab course of 8.1 months (range, 1.0–30) with a median of 14.2 2-week cycles (range, 1–53), predominantly Child–Pugh A (22/29) patients—12 Barcelona Clinic Liver Cancer (BCLC) B and 17 BCLC C—underwent 20 transarterial chemoembolization and 21 transarterial radioembolization LRTs at a median of 67 days (range, 48–609) after nivolumab initiation. Ten patients underwent multiple LRTs. During a median follow-up of 11.5 months (range, 1.8–35.1), no grade III/IV adverse events attributable to nivolumab were observed. There were five instances of grade III/IV hypoalbuminemia or hyperbilirubinemia within 3 months after LRT. There were no nivolumab-related deaths, and 30-day mortality after LRT was 0%.ConclusionsLRTs performed concurrently with nivolumab immunotherapy demonstrate an acceptable safety profile in patients with intermediate and advanced HCC. |
