Sintilimab combined with bevacizumab biosimilar as a conversion therapy in potentially resectable intermediate-stage hepatocellular carcinoma (HCC): Updated results of a phase II trial.

Authors

null

Huichuan Sun

Department of Liver Surgery & Transplantation Center, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China, Shanghai, China

Huichuan Sun , Xiaodong Zhu , Qiang Gao , Shuang-Jian Qiu , Ying-Hong Shi , Xiao-Ying Wang , Xiao-Wu Huang , Xin-Rong Yang , Yuan Ji , Yanrui Pang , Yi-Feng He , Yong-Feng Xu , Jie Liu , Mingquan Sun , Mei-Ling Li , Jin-Jin Zhu , Ying-Hao Shen , Cheng Huang , Jian Zhou , Jia Fan

Organizations

Department of Liver Surgery & Transplantation Center, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China, Shanghai, China, Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China, Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion (Ministry of Education), Fudan University, Shanghai, China, Zhongshan Hospital Liver Cancer Institute, Shanghai, China, Department of Pathology,Zhongshan Hospital, Fudan University, Shanghai, China, Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, Shanghai, China, Department of Liver Surgery and transplantation,Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China, Wake Forest University, Winston-Salem, USA, Winston-Salem, NC, Department of Liver Surgery and Transplantation, Zhongshan Hospital and Liver Cancer Institute, Fudan University, Shanghai, China, Department of Liver Surgery & Transplantation Center, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China

Research Funding

Pharmaceutical/Biotech Company
Innovent Biologics (Suzhou) Co. Ltd

Background: The combination of Sintilimab (a PD-1 antibody) and bevacizumab (bev) biosimilar improved progression-free survival and overall survival in unresectable or advanced HCC as compared with sorafenib in ORIENT-32 study and was approved as first-line treatment for unresectable HCC in China. We assessed the efficacy and safety of the combination therapy as conversion therapy for potentially resectable intermediate-stage HCC. Methods: Treatment-naïve patients (pts) with potentially resectable intermediate stage (BCLC stage B) HCC were enrolled in this phase II trial (NCT04843943). Eligible pts received sintilimab (200 mg, IV, D1) and bev (15 mg/kg, IV, D1) per 3 weeks. Tumor response and resectability were assessed every 6 weeks per RECIST v1.1. Pts with evaluations of partial response (PR) or at least two consecutive stable disease (SD) and eligible for R0 resection were referred for hepatectomy, then continued with sintilimab/bev for at most 12 months. Primary endpoints were event-free survival (EFS) (time from study enrollment to tumor progression, disease recurrence after surgery, or death from any cause) and treatment safety. Secondary endpoints included R0 resection rate, pathologic response, objective response rate (ORR), and disease control rate (DCR). Results: At data cutoff on Feb 7, 2023, 30 pts with BCLC-B stage HCC were enrolled. Of them, 25 pts (83.3%) were up-to-7 criteria out. The median follow-up time was 15.3 months (interquartile range [IQR] 13.8-17.6). ORR and DCR were 26.7% and 90.0% (8 PR and 19 SD). 17 pts (56.7%) met the pre-designated criteria for hepatectomy and received liver resection, including 7 pts were evaluated as PR and 10 as SD before surgery. The median time from initiation of sintilimab/bev to liver resection was 4.3 months (IQR 2.3-5.6). No postoperative mortality was observed. 2 pts had a pathological complete response. Median EFS was 13.8 months (95%CI, 10.3-17.3), and the 6-month and 12-month EFS rates were 76% and 60%, respectively. 3 pts died, and OS data was not mature. Most treatment-related AEs (TRAE) were grade 1-2, and grade 3/4 TRAEs occurred in 7 pts (23.3%). 9 serious adverse events occurred, and 3 of them were treatment associated. Conclusions: For pts with potentially resectable intermediate-stage HCC, sintilimab/bev in combination with liver resection was safe and may improve long-term survival. Clinical trial information: NCT04843943.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Track

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Sub Track

Hepatobiliary Cancer - Local-Regional Disease

Clinical Trial Registration Number

NCT04843943

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr e16220)

DOI

10.1200/JCO.2023.41.16_suppl.e16220

Abstract #

e16220

Abstract Disclosures