Treatment duration of adjuvant immune checkpoint inhibitor in hepatocellular carcinoma after curative resection: A prospective cohort study.

Abstract

e16266 Background: Adjuvant immune checkpoint inhibitors (ICIs) improve the recurrence-free survival for patients with hepatocellular carcinoma (HCC) after hepatic resection. However, the appropriateness of the treatment duration is unknown. This prospective cohort study aims to evaluate the effect of adjuvant ICIs duration in patients with HCC at high risk of recurrence after curative hepatic resection. Methods: Recurrence-free survival, overall survival, and adverse events were compared in patients receiving adjuvant ICIs therapy for more than 6 months or up to 6 months between March 2019 and March 2023. Patients who with HCC recurrence within 6 months after hepatic resection were excluded. Results: Of the 118 patients, 53 (44.9%) received longer than 6 months of adjuvant therapy, 65 (55.1%) received up to 6 months of adjuvant therapy. Recurrence-free and overall survivalwere significantly longer among patients who received longer than 6 months of adjuvant therapy than among those who received up to 6 months adjuvant therapy (HR 0.47, 95%CI 0.24–0.92, P = 0.021; HR 0.28, 95%CI 0.08–0.93, P = 0.045). However, patients who received more than 6 months of adjuvant therapy had a higher rate of adverse events than those who received up to 6 months of adjuvant therapy, especially grade 2 adverse events. Conclusions: Six months of adjuvant ICIs therapy may not be enough, but prolonged adjuvant therapy can significantly increase the incidence of adverse events. This study highlights the need to optimize the duration of adjuvant ICIs after curative resection for HCC in order to minimize risk of not only recurrence but also adverse events.