Concerning the treatment-related adverse events (TRAEs), the most common TRAEs in both arms were diarrhea, skin reactions, and hypertension. The rate of grade 3/4 AEs was [47%] in the doublet arm compared with 71% in the triplet arm. The majority of these grade 3/4 AEs were actually of grade 3; only 14% of the patients developed grade 4 TRAEs. There were no treatment-related deaths in either arm.What is the key takeaway from this research?
We demonstrated promising early efficacy of using nivolumab plus ipilimumab plus cabozantinib in advanced HCC. This triplet therapy is the first of its kind in patients with HCC, even though the treatment may result in a higher incidence of TRAEs.Where do you see this combination fitting into the treatment landscape for advanced HCC?
For patients with advanced HCC, we hope that, in the future, we can test the triplet combination in a randomized trial setting. Perhaps this kind of triplet combination can be suitable for patients with aggressive disease upon presentation.
There are a lot of immunotherapy/TKI combinations or immunotherapy/immunotherapy combinations, but this is the first that people have done an immunotherapy and immunotherapy plus a TKI.
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- Yau T, Zagonel V, Santoro A, et al. Nivolumab (NIVO) + ipilimumab (IPI) + cabozantinib (CABO) combination therapy in patients (pts) with advanced hepatocellular carcinoma (aHCC): results from CheckMate 040. J Clin Oncol. 2020;38(suppl; abstr 478).
- Exelixis announces results for combination of cabozantinib and nivolumab with or without ipilimumab in advanced hepatocellular carcinoma [news release]. Alameda, CA: Exelixis, Inc; January 24, 2020. bit.ly/2tR2Z6K. Accessed January 25, 2020.
- Yau T, Kang Y-K, Kim T-Y, et al. Nivolumab (NIVO) + ipilimumab (IPI) combination therapy in patients (pts) with advanced hepatocellular carcinoma (aHCC): results from CheckMate 040. J Clin Oncol. 2019;37(suppl; abstr 4012). doi: 10.1200/JCO.2019.37.15_suppl.4012.