Initial experience of anti-PD1 therapy with nivolumab in advanced hepatocellular carcinoma

Purpose: To evaluate efficacy and safety of anti-PD1 therapy with nivolumab for treatment of advanced hepatocellular carcinoma (HCC). Methods: From Jan 2016 to Jan 2017, eleven cases of HCC (average age of 51.8 year), 4 at stage B and 7 at stage C, according to Barcelona Clinic Liver Cancer staging, were treated with nivolumab. There were 4 patients with lung metastasis, 1 with portal vein tumor thrombus, 1 with abdominal metastasis and 1 with bone metastasis. The protocol was nivolumab, 3 mg/kg, on day 1, q3w. All patients were treated for more than 4 cycles. During anti-PD1 treatment period, 6 patients also received sorafenib and 1 patient received cytokine-induced killer cell therapy. Objective response and clinical adverse events were evaluated retrospectively. Results: Patients underwent a total of 80 cycles of nivolumab therapy, ranging between 4 and 18 cycles per patient. Nivolumab was associated with a disease control rate of 81.8%, with an objective response of 63.6% (Modified Response Evaluation Criteria in Solid Tumors). No adverse effects related to nivolumab were noted. Conclusion: Our experience shows that nivolumab could achieve acceptable outcome in HCC patients and may serve as an optional treatment, especially for patients who failed to gain a benefit from routine treatments.