Neoadjuvant immunotherapy for resectable hepatocellular carcinoma – Authors' reply

We thank Fangqiang Wei for their comments. Neoadjuvant immunotherapy is now standard for multiple tumour types, given improved survival outcomes. For patients with hepatocellular carcinomas, our trial 1 Marron TU Fiel MI Hamon P et al. Neoadjuvant cemiplimab for resectable hepatocellular carcinoma: a single-arm, openlabel, phase 2 trial. Lancet Gastroenterol Hepatol. 2022; 7: 219-229 Summary Full Text Full Text PDF PubMed Scopus (5) Google Scholar and Kaseb and colleagues' study 2 Kaseb AO Hasanov E Cao HST et al. Perioperative nivolumab monotherapy versus nivolumab plus ipilimumab in resectable hepatocellular carcinoma: a randomised, open-label, phase 2 trial. Lancet Gastroenterol Hepatol. 2022; 7 (18): 2018 Summary Full Text Full Text PDF Scopus (10) Google Scholar suggest neoadjuvant immunotherapy to be similarly promising, pending larger studies and longer follow-up.The potential of any perioperative treatment to increase the cure rate is particularly appealing in hepatocellular carcinoma because of its high rate of recurrence. Considering the substantial costs associated with subsequent locoregional therapies (eg, radiation, chemoembolisation, and radioembolisation) and the expense of systemic therapies in recurrent hepatocellular carcinoma, nearly any intervention that would preclude the need for these treatments would also be beneficial from a cost-effectiveness standpoint. Neoadjuvant immunotherapy for resectable hepatocellular carcinomaI read, with great interest, the results of the phase 2 trial published by Thomas Marron and colleagues.1 This clinical trial enrolled 21 patients with resectable hepatocellular carcinoma who received neoadjuvant cemiplimab. The authors have suggested the need for larger studies in the future, to evaluate the potential clinical benefit of preoperative PD-1 blockade in patients with resectable hepatocellular carcinoma. However, I would like to discuss two additional observations. Full-Text PDF Neoadjuvant cemiplimab for resectable hepatocellular carcinoma: a single-arm, open-label, phase 2 trialThis report is, to our knowledge, the largest clinical trial of a neoadjuvant anti-PD-1 monotherapy reported to date in hepatocellular carcinoma. The observed pathological responses to cemiplimab in this cohort support the design of larger trials to identify the optimal treatment duration and definitively establish the clinical benefit of preoperative PD-1 blockade in patients with hepatocellular carcinoma. Full-Text PDF