# Efficacy and safety of combined targeted therapy and immunotherapy versus targeted monotherapy in older patients with uHCC

## TL;DR

This study compares the effectiveness and safety of combining targeted therapy with immunotherapy versus using targeted therapy alone in older patients with unresectable liver cancer.

## Contribution

The study provides new evidence on the efficacy and safety of combination therapy in older patients with unresectable hepatocellular carcinoma.

## Key findings

- Combination therapy showed a higher objective response rate (29.4%) compared to monotherapy (3.6%).
- Median progression-free survival was longer with combination therapy (13.2 months) than with monotherapy (7.3 months).
- Combination therapy had a higher incidence of adverse events and drug withdrawal compared to monotherapy.

## Abstract

The prevalence of hepatocellular carcinoma (HCC) among older patients is rising due to the aging population. This study aimed to compare the efficacy and safety of targeted therapy alone versus its combination with immunotherapy in older patients (≥ 65 years old) with unresectable HCC (uHCC).

We retrospectively analyzed 158 patients aged ≥ 65 diagnosed with uHCC who received targeted therapy alone or in combination with immunotherapy from the CLEAP database between March 2019 and July 2023. The primary endpoint was overall survival (OS), with secondary endpoints including progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and safety assessments for adverse events (AEs).

The ORR was 3.6% in the targeted monotherapy group compared to 29.4% in the combination therapy group, while the DCRs were 53.6% and 54.9%, respectively. Survival analysis indicated a median PFS of 7.3 months for monotherapy versus 13.2 months for combination therapy (P = 0.137) and a median OS of 16.0 months versus 20.0 months, respectively (P = 0.140). AEs occurred in 44.6% of the monotherapy group and 58.8% in the combination therapy group, with 20.5% in the combination group withdrawing due to adverse reactions, significantly higher than in monotherapy group.

Among older patients with uHCC, the combination therapy demonstrated higher ORR and longer PFS and OS, although it had higher incidences of AEs and drug withdrawal.