Liver cancer, new results for double immunotherapy
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A new breakthrough in the treatment of advanced liver cancer, one of the most difficult to cure. This was highlighted by the Himalaya study on the combination of two immunotherapies, which today reports updated 4-year survival data: to date, this is the longest follow-up in patients with unresectable hepatocellular carcinoma (HCC), not treated with a prior systemic therapy and ineligible for locoregional treatment.
The results presented in Barcelona
The data, presented yesterday in Barcelona, at the World Congress on Gastrointestinal Cancer 2023 of the European Society of Medical Oncology (ESMO), show that durvalumab combined with a single dose of tremelimumab (the so-called Stride regimen) produced a clinically meaningful overall survival benefit and sustained: one in 4 patients is alive at four years. The combination reduced the risk of death by 22% compared with standard sorafenib treatment. Notably, 25.2% of patients treated with the STRIDE regimen were alive at four years compared with 15.1% of those treated with sorafenib. Treatment effects of the Stride regimen versus sorafenib were also maintained in all clinically relevant subgroups of patients alive at least after three years, regardless of the underlying liver disease etiology (hepatitis B, hepatitis C, or non-viral) or other characteristics. basic demographics.
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“The long-term survival data from the Himalaya study are unique in the panorama of advanced hepatocellular carcinoma – says Lorenza Rimassa, Associate Professor of Medical Oncology at Humanitas University and IRCCS Humanitas Research Hospital in Rozzano (Milan) -. It is important to note that one in four patients treated with the Stride regimen, based on dual immunotherapy, is alive at four years. No other therapeutic regimen has demonstrated these results to date. When compared to available historical data, only 7% of patients with advanced liver cancer are alive at five years.”
The Stride regime
This strategy, explains the expert, is based on an innovative approach of ‘immune priming’ with a single dose of tremelimumab followed by durvalumab monotherapy. This single administration of tremelimumab, at a higher than traditional dose, is able to provide a ‘boost’ to the immune response, while simultaneously offering an improvement in the safety profile, and therefore offering greater efficacy and tolerability. The combination of durvalumab and tremelimumab is approved for the treatment of adult patients with advanced or unresectable HCC and is approved in the European Union as first line.
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Liver cancer
About 75% of all primary liver cancers in adults are hepatocellular carcinoma. The treatment of hepatocellular carcinoma is complex because the tumor must be treated without underestimating the fact that the patient very often – 80-90% of cases – is affected by another very important pathology, chronic liver disease. Management of two serious comorbidities requires tolerable therapies that do not worsen residual liver function. More than half of patients have advanced stages of the disease, often at the first onset of symptoms.
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The role of immunotherapy in this tumor
The unique immune environment of liver cancer provides a clear rationale for studying drugs that harness the power of the immune system to treat HCC. The substantial four-year survival benefit demonstrated by durvalumab and tramelimumab in this advanced liver cancer setting supports the use of the Stride regimen to treat a large population of eligible patients globally,” concluded Susan Galbraith, Vice President Executive, Oncology R&D, AstraZeneca – These latest findings from the Himalaya study are part of a series of clinical trials that aim to provide innovative treatments to patients at various stages of liver cancer.”
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