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SIR 2025

Interventional Oncology

Traditional Poster

Session: Traditional Poster Presentations

40 - Adjuvant Immunotherapy After Transarterial Radioembolization in Patients with High-risk Hepatocellular carcinoma: A Single-Center, Single Arm Retrospective Study

Monday, March 31, 2025
12:10 PM – 1:10 PM CT
Location: Music City Center, Expo Poster Area
Purpose: Patients with high-risk features of hepatocellular carcinoma (HCC), such as large tumor burden, elevated alpha-fetoprotein (AFP), and vascular invasion (VI), are at risk of disease recurrence. Studies suggest that adjuvant immunotherapy may improve progression-free survival (PFS) in patients with resected or ablated high-risk HCC {1}. However, few studies have investigated the safety and efficacy of adjuvant immunotherapy after TARE in patients with high-risk HCC. We report PFS, overall survival (OS), objective response rate (ORR), and adverse events (AE) in a cohort of patients with high-risk HCC treated with TARE and adjuvant immunotherapy.  

Materials and Methods: In a single-center retrospective study, 21 patients who underwent TARE followed by initiation of immunotherapy within 2-10 weeks, between January 1, 2019 and December 31, 2023 were evaluated. Inclusion criteria included patients with Child-Pugh Score A-B7, tumor size of at least 8 cm, or tumor size < 8 cm and either elevated AFP or VI. The primary endpoint was PFS, with secondary endpoints of OS, rate of AEs, and ORR based on mRECIST criteria. AEs were defined according to National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. 

Results:

ORR was observed in 76.2% (16/21) patients (95% CI, 58.0-94.4 ). The median PFS from the index Y90 was 57 days (95% CI, 34.6 - 79.4). The median PFS from last imaging prior to index Y90 was 89 days (95% CI, 78.5 - 99.5). The median OS from index Y90 was 19.7 months (95% CI, 0.016 - 39.3). The median OS from last imaging prior to index Y90 was 20.3 months (95% CI, 1.7 - 38.9). 42.9% (9/21) of patients were noted to have grade 3 AE attributed to immunotherapy. No patients experienced grade 4 or 5 AE.  



Conclusion: Adjuvant immunotherapy and TARE in patients with high-risk HCC demonstrate high ORR with improved OS and PFS with expected treatment AE, consistent with known AE rates in the current literature. Future prospective studies with larger sample sizes are necessary to further demonstrate potential benefit of combined TARE and adjuvant therapy in high-risk HCC treatment.