Stivarga, Opdivo have similar survival outcomes in HCC
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Among patients with hepatocellular carcinoma who first failed Retevmo, Stivarga and Opdivo provided similar outcomes in terms of survival as second-line treatments, according to research presented at The Digital International Liver Congress.
Won-Mook Choi, of the department of gastroenterology at Asan Medical Center in South Korea, said that while both Stivarga (regorafenib, Bayer) and Opdivo (nivolumab, Bristol-Meyers Squibb) are approved for second-line treatment of HCC, their effectiveness has not been directly compared in a real-world setting.
“The aim of this study was to compare the effectiveness and safety between regorafenib and nivolumab, both of which have the most accumulated clinical experience as a second-line treatment after sorafenib failure in patients with hepatocellular carcinoma,” he said in his presentation.
Researchers retrospectively evaluated 373 patients with HCC who were treated with regorafenib (n = 223) or nivolumab (n = 150) as a second-line treatment after sorafenib failure between July 2017 and February 2019.
Choi and colleagues found that more patients in the nivolumab group achieved an objective response rate compared with the regorafenib group (13.3% vs. 4%; P = .002) and more experienced a durable clinical benefit (50.8% vs. 34%; P = .035).
Investigators also found that progression-free survival (HR = 0.85; 95% CI, 0.69–1.06), time to progression (HR = 0.95; 95% CI, 0.77–1.19) and overall survival (HR = 0.83; 95% CI, 0.64–1.07) did not differ between the two groups of patients. The objective response rate, however, was higher in the nivolumab group (13.3% vs. 4%; P = .002).
When Choi and colleagues compared the two drugs among treatment responders, defined as patients who achieved compete response, partial response or stable disease after first response evaluation (n = 59 in the nivolumab group; n = 104 in the regorafenib group), progression-free survival (HR = 0.5; 95% CI, 0.33–0.75), time to progression (HR = 0.48; 95% CI, 0.31–0.73) and overall survival (HR = 0.51; 95% CI, 0.31–0.87) were all longer in the nivolumab group.
“In the non-progressors, nivolumab showed significantly better survival outcomes compared with regorafenib, which is likely due to the durable responses of nivolumab,” Choi said.