Immunotherapy Efficacy in Advanced Hepatocellular Carcinoma in a Diverse and Underserved Population in the United States

Fernand Bteich, Kush Desai, Chenxin Zhang, Anahat Kaur, Rachel A. Levy, Lydia Bioh, Aaron Wang, Sharmin Sultana, Andreas Kaubisch, Milan Kinkhabwala, Sarah Bellemare, Shabnam Fidvi, Devaraju Kanmaniraja, Robert Berkenblit, Jee Young Moon, Adebola Adedimeji, Clara Y. Tow, Yvonne Saenger

Research output: Contribution to journalArticlepeer-review

Abstract

Background:  :   Incidence of hepatocellular cancer (HCC) in the Bronx is 61% higher than the rest of New York State. Underserved populations are not well represented in clinical trials of immune checkpoint inhibitors (ICI). Methods: Demographics were tabulated for 194 patients treated with ICI at the Montefiore-Einstein Comprehensive Cancer Center (MECCC) between 2017 and 2022. Categorical variables were analyzed by Chi-squared test, and survival was analyzed using Kaplan–Meier (KM) curves. Results: MECCC patients were 40.7% Hispanic and 20.6% Black, compared with 3% and 2%, respectively, in the landmark IMbrave 150 study. Median overall survival (mOS) on ICI was 9.0 months, 25.0 months for the 100 (51.5%) favorable-prognosis Child Pugh A (CPA) patients included in HCC clinical trials. Disease control rate (DCR) was 58.5% among 123 evaluable patients per mRECIST 1.1. Baseline liver function, as defined by CP and the Model for End-Stage Liver Disease-Sodium (MELD-Na), correlated with survival (p < 0.001). Hepatitis C Virus (HCV) and alcoholism were over-represented relative to National Cancer Institute (NCI) data (56.2% vs 4.7% and 38.7% vs 8.2%, respectively). HCV treatment correlated with prolonged survival in infected patients (p = 0.0017). AFP decline correlated with response (p = 0.001). Hispanic patients lived longer when clinical variables were controlled for (mOS 52 vs 23 months; p = 0.011). Conclusion: In an underserved HCC population, ICI yielded a DCR of 58.5% and low rates of severe toxicity. This work highlights ICI efficacy in minority groups, a need for earlier HCC diagnosis and for studies of genetic and environmental factors in Hispanics with HCC.

Original languageEnglish (US)
Pages (from-to)257-269
Number of pages13
JournalJournal of Hepatocellular Carcinoma
Volume11
DOIs
StatePublished - 2024

Keywords

  • checkpoint inhibitors
  • hepatocellular carcinoma
  • immunotherapy
  • minorities
  • systemic therapy

ASJC Scopus subject areas

  • Oncology
  • Hepatology

Fingerprint

Dive into the research topics of 'Immunotherapy Efficacy in Advanced Hepatocellular Carcinoma in a Diverse and Underserved Population in the United States'. Together they form a unique fingerprint.

Cite this