Dr. Li on Preoperative Immunotherapy in Hepatocellular Carcinoma

Daneng Li, MD, an assistant clinical professor in the Department of Medical Oncology and Therapeutics Research, and a medical oncologist at City of Hope, discusses an ongoing study of preoperative immunotherapy in patients with hepatocellular carcinoma (HCC).

A lot of focus in HCC has been placed on the use of immunotherapy in the frontline metastatic setting, says Li. One particular study (NCT03222076) of interest evaluated the use of either nivolumab (Opdivo) monotherapy or the combination of nivolumab and ipilimumab (Yervoy) in patients with resectable disease in the preoperative or adjuvant setting. Results from a preliminary analysis conducted by The University of Texas MD Anderson Cancer Center showed 3 partial complete responses in 8 patients.

The responders were subsequently able to undergo a successful resection, says Li. These findings are pushing the bar for immunotherapy; this approach is now being tested in the frontline setting for patients with early-stage HCC to determine whether or not immunotherapy has a preoperative or adjuvant role.

Ultimately, physicians are hoping to understand whether frontline immunotherapy has any utility in patients with borderline resectable disease, adds Li, and whether there are any means of selecting the patients who stand the greatest chance of benefitting from these therapies in the long-run.