Tremelimumab (day 1 only) and durvalumab in combination with transarterial chemoemobilization (TACE) in patients with hepatocellular carcinoma (HCC).

Authors

null

Jemma Buchalter

Mater Misericordiae University Hospital, Dublin, Ireland

Jemma Buchalter , Niamh Evans , Iseult Browne , Colm Mac Eochagain , Calvin Flynn , Hailey Kathryn Carroll , Marie Galligan , Michele Bourke , Amy Lester-Grant , Katherine Hoey , Ronan Ryan , Colin P Cantwell , Jeffrey McCann , Ray McDermott , Ross MacNicholas , Austin G Duffy

Organizations

Mater Misericordiae University Hospital, Dublin, Ireland, UCD CRC, School of Medicine, Dublin, Ireland, Mater Misercordiae University Hospital, Dublin, Ireland, St. James's Hospital, Dublin, Ireland, University College Dublin, Dublin, Ireland, St. Vincent's University Hospital, Dublin, Ireland, St. Vincents University Hospital, Dublin, Ireland, Mater Private, St Raphael's House, Dublin, Ireland

Research Funding

Pharmaceutical/Biotech Company

Background: TACE induces a peripheral anti-tumor immune response, which may be amplified by immune checkpoint inhibitors (ICI). Combining TACE with dual ICI therapy has been shown to be safe and feasible. Recent data has suggested that Day-1 only anti-CTLA4 dosing, at a higher level of 300mg, could lead to a stronger immune response, and drive a greater expansion than lower dose regimens, whilst maintaining a tolerable safety profile. This novel schedule has not previously been combined with TACE. Methods: Patients with HCC (Childs Pugh A/B7, Barcelona clinic liver cancer stage B/C; ECOG 0/1; sorafenib-naive or experienced) were enrolled in a pilot study of tremelimumab at 2 dose levels (DL1: 75mg IV q4-weekly x 4 and DL2: 300mg IV D1 only) in combination with durvalumab (1500mg IV q-28d) and TACE (D36 +/- 96 hours) until progression of disease (per irRECIST) or off-study criteria. Peripheral immune monitoring was performed and tumor biopsies were obtained at time of TACE. Results: 13 patients enrolled on study; N = 3 at DL1 and N = 10 at DL2. M:F 10:3. Median age 70 (65-74). BCLC B/C 4/9. Extrahepatic disease 6/7. Aetiology: NASH (N = 3), alcohol-related disease (N = 1), HCV (N = 2), hemochromatosis (N = 1), unknown (N = 6). 1 pt discontinued due to G3 colitis. All patients evaluable for response with 2/10 pts on DL2 experiencing PR (at 8 weeks) and overall 7/13 SD and 1/13 PD as best response. Updated PFS and OS data to be presented. Conclusions: Tremelimumab (Day 1 only) and Durvalumab in combination with TACE is safe and feasible in patients with HCC. Follow-up is ongoing and full safety and efficacy data will be presented. Clinical trial information: 2019-002767-98.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Track

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Sub Track

Hepatobiliary Cancer

Clinical Trial Registration Number

2019-002767-98

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr e16175)

DOI

10.1200/JCO.2022.40.16_suppl.e16175

Abstract #

e16175

Abstract Disclosures

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