Real-World Comparative Effectiveness of Nivolumab versus Pembrolizumab in Patients with Unresectable Hepatocellular Carcinoma

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Title:	Real-World Comparative Effectiveness of Nivolumab versus Pembrolizumab in Patients with Unresectable Hepatocellular Carcinoma
Authors:	Kuo, Hsin-Yu Han, Meng-Zhi Liao, Chih-Hsiang Lin, Yih-Jyh Wang, Chung-Teng Chen, Shang-Hung Chang, Ting-Tsung Chen, Po-Jun Lin, Sheng-Hsiang Chen, Chiung-Yu Chuang, Chiao-Hsiung Wu, I-Chin Wu, Juei-Seng Hong, Tzu-Chun Hsieh, Ming-Tsung Lee, Yang-Cheng Wu, Hung-Tsung Tsai, Hong-Ming
Contributors:	National Cheng Kung University National Cheng Kung University Hospital National Cheng Kung University China Medical University Taiwan Department of Environmental Resources Management, Chia Nan University of Pharmacy & Science National Cheng Kung University National Cheng Kung University Hospital National Cheng Kung University National Cheng Kung University Hospital National Health Research Institutes - Taiwan National Cheng Kung University National Cheng Kung University National Cheng Kung University Hospital National Cheng Kung University National Cheng Kung University National Cheng Kung University Hospital
Keywords:	checkpoint inhibitors therapy
Date:	2022
Issue Date:	2023-12-11 14:04:53 (UTC+8)
Publisher:	MDPI
Abstract:	Purpose: Immune checkpoint inhibitors are effective therapies for advanced hepatocellular carcinoma (HCC); however, comparisons of the clinical efficacy and safety profile for these drugs are still scarce. Thus, the aims of this study were to investigate the differences in efficacy and safety between nivolumab and pembrolizumab in unresectable HCC patients in a real-world setting. Patients and methods: A total of 115 patients who received treatment with nivolumab (n = 73) or pembrolizumab (n = 42) in combination with or without tyrosine kinase inhibitors was enrolled. Therapeutic response, survival outcomes, and safety profiles were compared among these groups. Multivariate analysis of survival response was performed using Cox proportional hazards regression. Results: Patients treated with pembrolizumab demonstrated a significantly higher objective response rate than those with nivolumab (38.1% vs. 15.1%; odds ratio 4.18, p = 0.005) regardless of the combination strategies. In addition, pembrolizumab performed a better overall survival (OS) than nivolumab, (34.9 vs. 9.5 months; hazard ratio (HR) = 0.39, p = 0.004). In subgroup analysis, pembrolizumab exhibited favorable OS than nivolumab for monotherapy (HR = 0.16, p = 0.001) or combination therapy (HR = 0.33, p = 0.006) as second-line or later-line (HR = 0.19, p = 0.001) therapy and those with (HR = 0.31, p = 0.006) or without (HR = 0.15, p = 0.004) well-compensated liver disease. The incidence of adverse events was comparable for both treatments. Conclusion: Both pembrolizumab and nivolumab had significant effects for HCC therapy, and pembrolizumab had a significant survival benefit as compared with nivolumab.
Relation:	PHARMACEUTICS, v.14, n.11, 2263
Appears in Collections:	[Dept. of Environmental Resources Management] Periodical Articles

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