The following article features coverage from the American Society of Clinical Oncology 2020 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

The combination of 300 mg tremelimumab plus durvalumab appeared to provide the best benefit-risk profile for the treatment of patients with advanced hepatocellular carcinoma (HCC), according to data presented by Robin Kate Kelley, MD, of the University of California, San Francisco, as part of the ASCO20 Virtual Scientific Program.

Previous studies combining the anti-CTLA4 and anti-PD-L1 drugs suggested that increasing doses of tremelimumab might induce a stronger immune response and enhance antitumor activity.

To examine that possibility, this study enrolled 332 patients with advanced HCC and randomly assigned them to single-agent durvalumab, single-agent tremelimumab, or 1 of 2 combinations: tremelimumab 300 mg plus durvalumab or tremelimumab 75 mg plus durvalumab.

There was overall tolerable toxicity across all arms, Dr Kelly said. Treatment-related serious adverse events occurred in 11% to about 25% across arms, with the highest rate in tremelimumab monotherapy. Treatment-related adverse events requiring discontinuation was 6% to 13% with the highest rate in tremelimumab monotherapy.


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The median overall survival was longest for the tremelimumab 300 mg plus durvalumab arm at 18.73 months. Overall survival was 13, 15, and 11 months for durvalumab monotherapy, tremelimumab monotherapy, and tremelimumab 75 plus durvalumab arms, respectively. The 12-month overall survival was also highest for the tremelimumab 300 mg plus durvalumab arm at 60.3% compared with 51.2%, 60.2%, and 49.2% for durvalumab monotherapy, tremelimumab monotherapy, and tremelimumab 75 plus durvalumab arms, respectively.

Finally, tremelimumab 300 mg plus durvalumab had the highest overall response rate of 24.0% compared with 10% or less in the 3 other arms

The researchers also said that a unique proliferative T cell profile was identified in patients given the 300 mg tremelimumab combination, suggesting “additive biologic activity for the combination.”

Read more of Cancer Therapy Advisor‘s coverage of the ASCO 2020 meeting by visiting the conference page.

Reference

Kelley RK, Sangro B, Harris WP, et al. Efficacy, tolerability, and biologic activity of a novel regimen of tremelimumab (T) in combination with durvalumab (D) for patients (pts) with advanced hepatocellular carcinoma (aHCC). Presented at: ASCO20 Virtual Scientific Program. J Clin Oncol. 2020;38(suppl):abstr 4508.