3:54 PM Abstract No. 304 Hepatobiliary toxicity in nivolumab-treated hepatocellular carcinoma in the presence or absence of transarterial chemoembolization

Abstract

To compare hepatobiliary toxicity in unresectable hepatocellular carcinoma (HCC) patients receiving nivolumab alone with those receiving nivolumab after transarterial chemoembolization (TACE). This single-institution retrospective study analyzed 28 patients who had received nivolumab therapy for treatment of HCC during 2018-2019. Patients that had undergone prior TACE (N = 11) had mean age of 68 years, with Child-Pugh Class A (64%), Class B (27%), and Class C (9%). Patients without prior TACE (N = 17) had a mean age of 64 years, with Child-Pugh Class A (59%), Class B (23%), Class C (18%). Hepatobiliary complications were graded using the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0), with the exception of portal hypertension, as a majority of patients had portal venous involvement prior to treatment. Comparison was made between a patient’s initial oncology evaluation for nivolumab and the follow-up visit after their last known treatment with nivolumab (average 127 ± 118 days). Patients that had undergone prior TACE had an average of 2 TACE treatments and 4 cycles (range, 1 to 17) of nivolumab, with an average of 215 days between last TACE treatment to initiation of nivolumab. Patients without prior TACE had undergone an average of 5 cycles (range, 1 to 24) of nivolumab. Hepatobiliary complications occurred in 45% (5/11) of patients that had undergone prior TACE, which included of CTCAE v5.0 grade I (27%, N = 3) and grade 3 (18%, N = 2) complications. Hepatobiliary complications occurred in 47% (8/17) patients that had not undergone TACE, which included grade 1 (18%, N = 3), grade 2 (12%, N = 2) and grade 3 (18%, N = 3) complications. Prior treatment with TACE did not result in increased hepatobiliary toxicity in patients undergoing treatment with nivolumab.