Observational studyLiver international : official journal of the International Association for the Study of the Liver2023
Progression patterns and therapeutic sequencing following immune checkpoint inhibition for hepatocellular carcinoma: An international observational study.
Observational study in Liver international : official journal of the International Association for the Study of the Liver, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 35 citations in OpenAlex.
- Disease Complexity and Nodule-Specific Responses to Atezolizumab plus Bevacizumab in Advanced Hepatocellular Carcinoma.Liver cancer · 2026Article
- Advancing Systemic Treatment beyond First Line for Advanced Hepatocellular Carcinoma.Current oncology reports · 2026Review
- Pattern of progression and post-progression survival following transarterial embolisation: An analysis of the TACE-2 and TACTICS trials.JHEP reports : innovation in hepatology · 2026Article
- Durable Disease Control With Atezolizumab Plus Bevacizumab but Limited Post-Progression Outcomes: A Multicenter Real-World Study in Advanced Hepatocellular Carcinoma.Cancer medicine · 2026Article
- Immune Checkpoint Inhibitors Beyond Progression in Various Solid Tumors: A Systematic Review and Pooled Analysis.Journal of clinical medicine · 2025Review
- Transarterial chemoembolization for advanced hepatocellular carcinoma after failure of first-line systemic treatment: a single-center case series.Discover oncology · 2025Article
- Efficacy of atezolizumab plus bevacizumab for unresectable HCC: Systematic review and meta-analysis of real-world evidence.JHEP reports : innovation in hepatology · 2025Article
- Article
- Lenvatinib versus sorafenib as second-line therapy following progression on atezolizumab-bevacizumab in patients with unresectable hepatocellular carcinoma: a multicenter retrospective study from Korea and Japan.Journal of cancer research and clinical oncology · 2025Article
- Effectiveness and Safety of Systemic Therapy and Stereotactic Body Radiotherapy in Oligoprogressive and Oligometastatic Hepatocellular Carcinoma.Journal of hepatocellular carcinoma · 2025Article
- Prognostic significance of reduced handgrip strength in patients with unresectable hepatocellular carcinoma receiving HAIC combined with targeted immunotherapy.Frontiers in immunology · 2025Article
- Role of immune checkpoint inhibitor combinations in resectable and unresectable, embolization-eligible hepatocellular carcinoma.Therapeutic advances in medical oncology · 2025Review
- Safety and Efficacy of Atezolizumab/Bevacizumab in Patients with Hepatocellular Carcinoma and Impaired Liver Function: A Systematic Review and Meta-Analysis.Liver cancer · 2024Article
- Review
- Regorafenib for patients with progression of advanced hepatocellular carcinoma after treatment with atezolizumab plus bevacizumab: a case series.Journal of gastrointestinal oncology · 2024Article
- Efficacy and predictive factors of transarterial chemoembolization combined with lenvatinib plus programmed cell death protein-1 inhibition for unresectable hepatocellular carcinoma.World journal of gastrointestinal oncology · 2024Article
- Article
- The Role of Timing of Progression and Early Salvage Surgery in Unresectable Hepatocellular Carcinoma Treated with TACE Plus TKIs and PD‑1 Inhibitors.Journal of hepatocellular carcinoma · 2024Article
- Efficacy and Safety of Re-Challenging PD-1 Inhibitors in Second-Line Treatment in Metastatic Nasopharyngeal Carcinoma Previously Treated with Chemotherapy and PD-1 Inhibitors.Cancer management and research · 2024Article
- Progression patterns and therapeutic sequencing following immune checkpoint inhibition for hepatocellular carcinoma: An international observational study.Liver international : official journal of the International Association for the Study of the Liver · 2023Observational
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Authors and funding
36 authors at 18 institutions in 7 countries.
Funding
Abstract
BACKGROUND AND
aimsDifferent approaches are available after the progression of disease (PD) to immune checkpoint inhibitors (ICIs) for hepatocellular carcinoma (HCC), including the continuation of ICI, treatment switching to tyrosine kinase inhibitors (TKIs) and cessation of anticancer therapy. We sought to characterise the relationship between radiological patterns of progression and survival post-ICI, also appraising treatment strategies.
methodsWe screened 604 HCC patients treated with ICIs, including only those who experienced PD by data cut-off. We evaluated post-progression survival (PPS) according to the treatment strategy at PD and verified its relationship with radiological patterns of progression: intrahepatic growth (IHG), new intrahepatic lesion (NIH), extrahepatic growth (EHG), new extrahepatic lesion (NEH) and new vascular invasion (nVI).
resultsOf 604 patients, 364 (60.3%) experienced PD during observation. Median PPS was 5.3 months (95% CI: 4.4-6.9; 271 events). At the data cut-off, 165 patients (45%) received no post-progression anticancer therapy; 64 patients (17.6%) continued ICI beyond PD. IHG (HR 1.64 [95% CI: 1.21-2.22]; p = .0013) and nVI (HR 2.15 [95% CI: 1.38-3.35]; p = .0007) were associated with shorter PPS. Multivariate models adjusted for progression patterns, treatment line and albumin-bilirubin grade and Eastern Cooperative Oncology Group performance status at PD confirmed receipt of ICI beyond PD with (HR 0.17, 95% CI: 0.09-0.32; p < .0001) or without subsequent TKI (HR 0.39, 95% CI: 0.26-0.58; p < .0001) as predictors of prolonged PPS versus no anticancer therapy.
conclusionsICI-TKI sequencing is a consolidated option in advanced HCC. nVI and IHG predict a poorer prognosis. Despite lack of recommendation, the continuation of ICI beyond progression in HCC is adopted clinically: future efforts should appraise which patients benefit from this approach.
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