Cabozantinib plus atezolizumab in advanced hepatocellular carcinoma and the role of adjuvant antiviral therapy.

Abstract

The treatment landscape for advanced hepatocellular carcinoma has changed greatly with the introduction of immune checkpoint inhibitors in addition to novel molecularly targeted agents such as anti-PD-1, anti-PD-L1, and anti-VEGF agents. 1 Llovet JM Castet F Heikenwalder M et al. Immunotherapies for hepatocellular carcinoma. Nat Rev Clin Oncol. 2022; 19: 151-172 Crossref PubMed Scopus (139) Google Scholar In phase 3 studies, anti-PD-1 and anti-PD-L1 in combination with anti-VEGF or anti-CTLA4 therapies have shown significantly better outcomes as first-line therapies compared with sorafenib. 2 Finn RS Qin S Ikeda M et al. Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma. N Engl J Med. 2020; 382: 1894-1905 Crossref PubMed Scopus (2022) Google Scholar , 3 Ren Z Xu J Bai Y et al. Sintilimab plus a bevacizumab biosimilar (IBI305) versus sorafenib in unresectable hepatocellular carcinoma (ORIENT-32): a randomised, open-label, phase 2-3 study. Lancet Oncol. 2021; 22: 977-990 Summary Full Text Full Text PDF PubMed Scopus (153) Google Scholar , 4 Abou-Alfa GK Chan SL Kudo M et al. Phase 3 randomized, open-label, multicenter study of tremelimumab (T) and durvalumab (D) as first-line therapy in patients (pts) with unresectable hepatocellular carcinoma (uHCC): HIMALAYA. Proc Am Soc Clin Oncol. 2022; 40 (abstr).: 379 Crossref Google Scholar Cabozantinib plus atezolizumab versus sorafenib for advanced hepatocellular carcinoma (COSMIC-312): a multicentre, open-label, randomised, phase 3 trialCabozantinib plus atezolizumab might be a treatment option for select patients with advanced hepatocellular carcinoma, but additional studies are needed. Full-Text PDF Open Access