Durvalumab monotherapy in unresectable HCC
Medically reviewed by Louis-Antoine Mullie, MD.
Answer
Durvalumab monotherapy has demonstrated efficacy in the treatment of unresectable hepatocellular carcinoma (HCC), as evidenced by several studies and guidelines.
Efficacy of durvalumab monotherapy
- HIMALAYA study: The phase III HIMALAYA study evaluated the efficacy of durvalumab monotherapy in patients with unresectable HCC who were naïve to previous systemic treatment. The study found that durvalumab monotherapy was noninferior to sorafenib in terms of overall survival (OS)
- CheckMate 040 study: The CheckMate 040 study, which included both sorafenib-naive and sorafenib-experienced patients with advanced HCC, demonstrated that nivolumab monotherapy, another PD-1 inhibitor, provided durable clinical benefit with manageable safety. This suggests a potential role for PD-1 inhibitors like durvalumab in this patient population
Guidelines on durvalumab monotherapy
- ASCO 2024 guidelines: The ASCO 2024 guidelines suggest offering durvalumab as a first-line therapy if atezolizumab plus bevacizumab and durvalumab plus tremelimumab are contraindicated
- BSG 2024 guidelines: The BSG 2024 guidelines recognize that single-agent durvalumab is noninferior to sorafenib in terms of overall survival and may be considered a first-line therapy when combination therapy is contraindicated
In conclusion, durvalumab monotherapy has demonstrated efficacy in the treatment of unresectable HCC, as evidenced by clinical trials and supported by guidelines. However, the choice of therapy should be individualized based on the patient's specific clinical context and potential contraindications to other therapies.
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