ArticleCancer medicine2023
Comparison of nivolumab and sorafenib for first systemic therapy in patients with hepatocellular carcinoma and Child-Pugh B cirrhosis.
Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- A network meta-analysis of first-line treatment options for patients with Child-Pugh class B functional hepatocellular carcinoma: comparison of efficacy and safety.Frontiers in pharmacology · 2025Pooled it
- Beyond Contraindication-Based Selection: The Unmet Need for Predictive Biomarkers in First-Line Immunotherapy for Advanced HCC.Targeted oncology · 2026Article
- Phase II trial with nivolumab and sorafenib in HCC identified enrichment of immunosuppressive monocytes in patients with Child-Pugh B liver dysfunction.JHEP reports : innovation in hepatology · 2026Article
- Article
- Impact of Child Pugh B Stage for the Treatment of Advanced HCC.Journal of hepatocellular carcinoma · 2026Review
- Patients with uHCC and Child-Pugh B8/9 also benefit from a combination of antiangiogenic agents and PD-1 inhibitors: a multicenter real-world study.Acta oncologica (Stockholm, Sweden) · 2025Article
- Systemic Treatment for Unresectable Hepatocellular Carcinoma: A Surgeon's Perspective.Journal of hepatocellular carcinoma · 2025Review
- Future perspectives on immunotherapy for hepatocellular carcinoma.Therapeutic advances in medical oncology · 2025Review
- Primary Prophylaxis for High-Risk Varices in Patients with Hepatocellular Carcinoma and Portal Vein Tumor Thrombus Delayed Hepatic Decompensation: A Retrospective, Propensity Score Matching Study.Journal of hepatocellular carcinoma · 2025Article
- Contemporary Systemic Therapy Approaches for Unresectable Hepatocellular Carcinoma.Advances in oncology · 2024Article
- Review
- The State of Systematic Therapies in Clinic for Hepatobiliary Cancers.Journal of hepatocellular carcinoma · 2024Review
- Current Landscape of Immune Checkpoint Inhibitor Therapy for Hepatocellular Carcinoma.Current oncology (Toronto, Ont.) · 2023Review
- Management of Hepatocellular Carcinoma in Decompensated Cirrhotic Patients: A Comprehensive Overview.Cancers · 2023Review
- Comparison of nivolumab and sorafenib for first systemic therapy in patients with hepatocellular carcinoma and Child-Pugh B cirrhosis.Cancer medicine · 2023Article
- Real-World Use of Immunotherapy for Hepatocellular Carcinoma.Pragmatic and observational research · 2023Review
- The effect of liver disease on hepatic microenvironment and implications for immune therapy.Frontiers in pharmacology · 2023Review
- Review
- Hepatocellular Carcinoma: Current Therapeutic Algorithm for Localized and Advanced Disease.Journal of oncology · 2022Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPatients with decompensated cirrhosis are excluded or underrepresented in clinical trials of systemic therapies for hepatocellular carcinoma (HCC) and comparisons of available therapies are lacking. We aimed to compare overall survival for patients with HCC and Child-Pugh B cirrhosis treated with nivolumab or sorafenib as first systemic treatment.
methodsWe performed a retrospective cohort study in patients with HCC and Child-Pugh B cirrhosis treated at Veterans Affairs medical centers to compare overall survival, adverse events, and reason for discontinuation of therapy between patients treated with nivolumab or sorafenib as first systemic treatment. All statistical tests were 2-sided.
resultsOf those meeting inclusion criteria, 431 patients were treated with sorafenib and 79 with nivolumab. Median OS was 4.0 months (95% CI 3.5-4.8) in the sorafenib cohort and 5.0 months (95% CI 3.3-6.8) in the nivolumab cohort. In the multivariable Cox proportional hazards model, nivolumab was associated with a significantly reduced hazard of death compared to sorafenib (HR 0.69; 95% CI 0.52-0.91; p = 0.008). In a secondary analysis using propensity score methods, results did not reach statistical significance (HR 0.77; 95% CI 0.55-1.06; p = 0.11). Treatment was discontinued due to toxicity in 12% of patients receiving nivolumab compared to 36% receiving sorafenib (p = 0.001).
conclusionIn patients with HCC and Child-Pugh B cirrhosis, nivolumab treatment may be associated with improved overall survival and improved tolerability compared to sorafenib and should be considered for the first systemic treatment in this population.
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