OncoTargets and Therapy (Nov 2019)
Evaluating the Safety and Efficacy of Nivolumab in Patients with Advanced Hepatocellular Carcinoma: Evidence to Date
Abstract
Sri Harsha Tella,1 Amit Mahipal,2 Anuhya Kommalapati,3 Zhaohui Jin2 1Department of Internal Medicine, University of South Carolina School of Medicine, Columbia, SC, USA; 2Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA; 3Department of Hematology and Medical Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USACorrespondence: Zhaohui JinDepartment of Medical Oncology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USATel +1507-293-0487Fax +1507-284-1803Email [email protected]: Hepatocellular carcinoma (HCC) is the most common primary liver cancer with a dismal prognosis, especially when diagnosed at advanced stages. Surgical resection of the primary lesion, liver-directed therapies, and orthotropic liver transplantation are employed in localized disease depending upon the clinical status, underlying liver function, the size, and location of the liver lesions. Systemic therapy plays a critical role in the management of advanced HCC. Sorafenib had remained as the only United States Food and Drug Administration (US-FDA)-approved systemic therapeutic agent for approximately a decade since its approval in 2007, until the advent of immunotherapy and a better understanding of HCC molecular pathogenesis changed the landscape of advanced HCC management. Lenvatinib was approved as an alternative first-line agent, whereas regorafenib, nivolumab, pembrolizumab, ramucirumab, and cabozantinib were approved as second-line agents for HCC patients who could not tolerate or whose disease progressed on sorafenib. Nivolumab and pembrolizumab are the two immunotherapeutic agents that were conditionally approved by the US-FDA based on the encouraging results in Phase I/II trials. This review discusses the potential role of immunotherapy in advanced HCC with a special focus on nivolumab.Keywords: liver cancer, immunotherapy, nivolumab, lenvatinib, sorafenib
