Aim: The subsequent treatments for patients with hepatocellular carcinoma (HCC) resistant to immunotherapy remain unclear. This study aimed to identify optimal treatments for HCC patients with progression after anti-PD-1 therapy. Methods: The authors retrospectively analyzed 197 HCC patients with progressive disease after anti-PD-1 treatment. These patients were classified into initial resistant and secondary resistant groups. Results: In the initial resistant group, subsequent treatment with PD-1 antibody plus locoregional therapy prolonged post-progression survival and overall survival (p = 0.025 and 0.029, respectively). In the secondary resistant group, subsequent treatment did not improve the prognosis of patients. Conclusion: Subsequent PD-1 antibody plus locoregional therapy could achieve survival benefits in HCC patients initially resistant to anti-PD-1 immunotherapy.
Keywords: PD-1; hepatocellular carcinoma; immunotherapy; resistance; subsequent treatments.
Lay abstract This study explored the optimal subsequent treatments for patients with hepatocellular carcinoma resistant to anti-PD-1 therapy. Patients were classified into initial resistant and secondary resistant groups according to whether they had responses to previous anti-PD-1 immunotherapy. By evaluating the prognosis of different treatment modalities in the initial and secondary resistant groups, the authors found that subsequent PD-1 antibody plus locoregional therapy provided survival benefits for patients with hepatocellular carcinoma initially resistant to anti-PD-1 immunotherapy. As for patients with secondary resistance, the optimal subsequent treatments need to be further explored.