Durvalumab-Tremelimumab Combo Noninferior to Comparable HCC First-Line Therapies

Investigators who analyzed 9 studies of treatment for unresectable hepatocellular carcinoma (HCC) found that “atezolizumab plus bevacizumab was not statistically superior to durvalumab plus tremelimumab (HR 0·74; 95% CI 0·52-1·06) and sintilimab plus IBI305 (HR 1·02; 95% CI 0·67-1·55) in reducing the risk of death,” according to a recent report in Liver Cancer.

The authors noted that head-to-head comparison of first-line treatments for HCC have been lacking. They conducted a literature search in MEDLINE, the Cochrane library, and Embase) to identify studies of HCC treatment published between January 2007 and February 2022.

“We included phase III randomised controlled trials that tested immune-checkpoint inhibitors or tyrosine kinase inhibitors, including sorafenib, lenvatinib and donafenib, and evaluated as primary end-point overall survival (OS) or progression-free survival (PFS),” the authors explained, while excluding studies of locoregional therapies.

The final analysis showed that “atezolizumab plus bevacizumab reduced the risk of death compared to placebo (HR 0·40; 95% CI 0·28-0·57), sorafenib (HR 0·58; 95% CI 0·42-0·80), lenvatinib (HR 0·63; 95% CI 0·44-0·89), atezolizumab plus cabozantinib (HR 0·64; 95% CI 0·43-0·97), nivolumab (HR 0·68; 95% CI 0·48-0·98) and donafenib (HR 0·69; 95% CI 0·48-0·99),” the authors wrote. “Atezolizumab plus bevacizumab was not statistically superior to durvalumab plus tremelimumab (HR 0·74; 95% CI 0·52-1·06) and sintilimab plus IBI305 (HR 1·02; 95% CI 0·67-1·55) in reducing the risk of death. Efficacy was associated with a higher risk of grade 3 adverse events.”

—Rebecca Mashaw

Reference:

Fulgenzi CAM, D'Alessio A, Airoldi C, et al. Comparative efficacy of novel combination strategies for unresectable hepatocellular carcinoma: A network metanalysis of phase III trials. Eur J Cancer. 2022;174:57-67. DOI:https://doi.org/10.1016/j.ejca.2022.06.058