Impact of Immunotherapy on the Care Patterns and Outcomes of Patients with Advanced Hepatocellular Carcinoma - 25/01/25
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Highlights |
• | There was an increase in immunotherapy use in advanced HCC from 2010 to 2021 |
• | The use of immunotherapy was associated with OS benefits in advanced HCC |
• | There was a large shift toward systemic therapy use for palliative care |
• | Systemic therapy showed significantly better OS compared to surgical palliation |
• | Hispanic ethnicity and low income are associated with not receiving immunotherapy |
Abstract |
Background |
Modern immunotherapy with checkpoint inhibitors revolutionized cancer treatment and outcomes. This study aims to demonstrate how immunotherapy has impacted the national landscape of systemic treatment and palliative care in advanced hepatocellular carcinoma (HCC).
Methods |
Retrospective cohort selecting patients from the U.S.-based National Cancer Database (NCDB) with clinical stages T3b/T4 and stage IV HCC from 2010 to 2021. We performed a multivariable analysis using the Cox proportional hazard for overall survival (OS) comparisons and a logistic regression model to study immunotherapy use.
Results |
Immunotherapy use increased from 0.27% in 2010 to 33.80% in 2021. The median OS survival (in months) was 2 for untreated patients, 7.20 for chemotherapy, and 7.46 for immunotherapy. There was a better OS with immunotherapy (HR 0.59, 95% CI 0.56-0.62). Systemic therapy for palliation increased from 14.41% in 2010 to 25.32% in 2021. Compared to surgical palliation, radiation (HR 0.61, 95% CI 0.52-0.71) and systemic palliative (HR 0.59, 95% CI 0.51-0.69) therapies improved OS.
Conclusion |
From 2010 to 2021, there was a significant increase in the use of immunotherapy, parallel to a large shift toward systemic therapy use for palliative care in patients with advanced HCC. Immunotherapy was associated with a significant OS benefit in the palliative setting.
Le texte complet de cet article est disponible en PDF.Keywords : systemic therapy, checkpoint inhibitors, palliative care
Plan
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