Tremelimumab Plus Imfinzi Regimen Boosts Liver Cancer Survival

Data from a phase 3 trial show that frontline tremelimumab plus Imfinzi improved overall survival in patients with liver cancer.

Tremelimumab plus Imfinzi (durvalumab) led to an improved overall survival benefit compared with Nexavar (sorafenib) when given as the first treatment for patients with hepatocellular carcinoma (HCC; the most common type of liver cancer) who are not eligible for resection or local treatment, according to findings from the phase 3 HIMALAYA clinical trial.

The two-drug regimen has been dubbed the STRIDE regimen (single tremelimumab regular interval durvalumab), and not only improved the length of time that patients lived, but also had a favorable safety profile and did not increase liver-related side effects.

“HIMALAYA is the first phase III trial to add a novel single priming dose of an anti-CTLA4 antibody to another checkpoint inhibitor, (Imfinzi). This serves to boost the patient’s own immune system against their liver cancer, aiming to maximize long-term survival with minimal side effects. This is very exciting news for our patients,” said Dr. Ghassan Abou-Alfa, attending physician at Memorial Sloan Kettering Cancer Center and principal investigator of HIMALAYA, said in a statement.

Since the regimen activates patients’ immune systems to fight cancer, they should watch out for immune-related side effects, which can be severe. Most commonly observed in patients prescribed STRIDE were pneumonitis, colitis, hepatitis and endocrinopathies (disease of the adrenal gland).

More data from the HIMALAYA trial will be presented at an upcoming oncology meeting. For now, the findings are particularly exciting, especially since current statistics state that only about 3% of patients with advanced HCC live for five years or longer.

“Inhibition of CTLA-4 has shown the ability to drive benefit particularly in the tail of the survival curve in several settings. This is the first time a dual immunotherapy regimen has improved overall survival as a 1st-line treatment for patients with unresectable liver cancer for whom treatment options are limited and long-term outcomes are poor,” said Susan Galbraith, executive vice president, Oncology R&D at AstraZeneca (the manufacturer of Imfinzi), said in a statement.

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