Systemic treatment of hepatocellular carcinoma: standard of care in China and elsewhere
Mené sur 217 patients atteints d'un carcinome hépatocellulaire de stade avancé, cet essai de phase II évalue l'efficacité, du point de vue du taux de réponse objective et de la survie globale à 6 mois, et la toxicité du camrélizumab, un anti-PD-1 dispensé par voie intaveineuse (durée médiane de suivi : 12,5 mois)
Hepatocellular carcinoma is the fifth most common cancer and second leading cause of cancer-related death globally. More than half of all patients are in China. For nearly 10 years, sorafenib was the only drug to have shown survival benefit in advanced hepatocellular carcinoma. Regorafenib, lenvatinib, cabozantinib, and ramucirumab have given positive results in phase 3 trials. From 2008 to 2017, however, many phase 3 trials testing new drugs in first or second lines failed, despite promising results observed in the early phases. Reasons for those failures have been discussed previously: poor understanding of drivers of progression, flaws in trial design, underestimation of liver toxicity, marginal antitumour activity, and an absence of trial enrichment with adequate biomarkers of benefit. Many histology-based, molecular-based or immune-based classifications have now been published to assist that enrichment.
The Lancet Oncology , commentaire, 2019