AUTHOR=Kuo Yuan-Hung , Yen Yi-Hao , Chen Yen-Yang , Kee Kwong-Ming , Hung Chao-Hung , Lu Sheng-Nan , Hu Tsung-Hui , Chen Chien-Hung , Wang Jing-Houng 

TITLE=Nivolumab Versus Regorafenib in Patients With Hepatocellular Carcinoma After Sorafenib Failure

JOURNAL=Frontiers in Oncology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.683341

DOI=10.3389/fonc.2021.683341

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>Nivolumab and regorafenib are approved second-line therapies for patients with hepatocellular carcinoma (HCC) after sorafenib failure. This study compared the effectiveness of nivolumab and regorafenib following sorafenib.</p></sec><sec><title>Methods</title><p>We retrospectively enrolled HCC patients who had undergone nivolumab or regorafenib after sorafenib failure. Treatment response, treatment-related adverse events (TRAE) and clinical outcomes of study patients were recorded and analyzed.</p></sec><sec><title>Results</title><p>A total of 90 patients (male/female: 67/23, mean age: 63 years) were enrolled, including 32 patients in the Nivolumab group and 58 patients in the Regorafenib group. The Nivolumab group had better objective response rates (16% <italic>vs</italic> 6.4%) and disease control rates (44% <italic>vs</italic> 31.9%) than the Regorafenib group, but there was no statistical difference. The comparison of time to progression (3.0 months <italic>vs</italic> 2.6 months, p=0.786) and overall survival (OS) (14 months <italic>vs</italic> 11 months, p = 0.763) between Nivolumab and Regorafenib groups were also insignificant. Regarding number of TRAE incidences, the Nivolumab group was significantly lower than the Regorafenib group (37.5% <italic>vs</italic> 68%). After cession of nivolumab/regorafenib, 34 patients (37.8%) (Nivolumab group/Regorafenib group: 11/23) could afford the following therapies. Concerning sequential systemic therapies, 17 patients (18.9%) received third-line therapy, whereas six patients (6.7%) could move to fourth-line therapy. In multivariable analysis, patients who achieved disease control were associated with improved OS (hazard ratio, 0.18; 95% confidence interval, 0.07–0.46; p&lt;0.001) after adjusting Child-Pugh class and post-treatment.</p></sec><sec><title>Conclusions</title><p>After sorafenib failure, using nivolumab or regorafenib both illustrated promising treatment outcomes.</p></sec>