AstraZeneca's Imfinzi and Merck's Keytruda are poised to reshape liver cancer treatment, offering new hope for patients who have seen limited progress in decades. Two late-stage studies, recently published in The Lancet, highlight the potential of these drugs, particularly when used in combination with other therapies and local treatments.
The studies focused on patients with liver cancer that could not be treated with surgery. The results indicated that the combination of Imfinzi or Keytruda with other drugs and a local therapy significantly delayed the progression of the disease. This marks a significant advancement, as roughly a quarter of liver cancer patients are ineligible for surgery or other curative therapies.
Key Findings from the Clinical Trials
The Keytruda study revealed that patients treated with Keytruda, Eisai Co.’s Lenvima, and transarterial chemoembolisation (TACE) experienced an average of 14.6 months without cancer progression. In contrast, the control group, which received only TACE, had a progression-free survival of 10 months. Josep Llovet, director of Mount Sinai’s Liver Cancer Program and co-lead researcher for the Keytruda study, hailed the data as "a breakthrough after 20 years."
In the Imfinzi trial, patients who received Imfinzi, Roche Holding AG’s Avastin, and TACE saw their cancer progress after 15 months. This was compared to 10 months for patients taking Imfinzi alone and 8.2 months for those who received a placebo alongside TACE.
Implications for Clinical Practice
The positive outcomes from these studies are expected to influence future treatment guidelines for liver cancer. The combination therapies offer a valuable option for patients whose tumors are not amenable to surgical removal, addressing a critical unmet need in this patient population. The last major advancement for these patients was in the early 2000s when studies showed that chemoembolisation helped patients.
Chemoembolisation, a procedure involving the injection of chemotherapy drugs and an embolic agent directly into the tumor to cut off its blood supply, has been a cornerstone of liver cancer treatment. The addition of checkpoint inhibitors like Imfinzi and Keytruda to this approach represents a significant step forward in improving patient outcomes.
