Dr Li on the Impact of Immune-Related Adverse Effects in HCC

Daneng Li, MD, associate professor, Department of Medical Oncology & Therapeutics Research, co-director, Neuroendocrine Tumor Program, City of Hope, discusses how immune-related adverse effects (AEs) can affect the treatment of patients with gastrointestinal cancer, specifically those with unresectable hepatocellular carcinoma (HCC), and highlights the correlation between immune-related AEs and positive treatment outcomes in patients with HCC who received the Single Tremelimumab-actl (Imjudo) Regular Interval Durvalumab (Imfinzi; STRIDE) regimen in the phase 3 HIMALAYA trial (NCT03298451).

Immune-related AEs that occur when treating patients with gastrointestinal cancer can be complex, Li begins. Li shares that he typically will explain to his patients that if they are experiencing some mild immune-related AEs, that may be a good thing. These immune-related AEs may be a sign of the immune system’s activity and its potential actions against the tumor itself, Li explains.

Immune-related AEs to be aware of in patients with gastrointestinal cancer include signs of new itchiness or a minor rash, as well as some treatment-related effects on the patients’ thyroid function, Li expands. Those are common early immune-related AEs that oncologists see, and they are reassuring to patients, who are often worried about these AEs, according to Li. Telling patients that these immune-related AEs could be an early sign of immune activation provides them with reassurance, Li says.

Immune-related AEs were associated with positive treatment outcomes in a subgroup analysis of the HIMALAYAtrial, Li notes. The randomized, open-label, multi-center, global HIMALAYA trial included patients with advanced HCC who had received no prior systemic therapy for unresectable HCC. This trial aimed to assess the efficacy and safety of the STRIDE regimen or durvalumab monotherapy vs sorafenib (Nexavar). A subgroup analysis of the data showed that patients who received the STRIDE regimen and experienced immune-related AEs tended to have longer overall survival compared those who did not have immune-related AEs, Li concludes.