Liver cancer is the third most common cause of cancer-related mortality worldwide, with over 780,000 deaths in 2018. About 90% of liver cancer cases are hepatocellular carcinoma (HCC), a prototype of inflammation-driven cancer, leading to a robust rationale for the exploration of immune therapy. Previously approved agents for first-line therapy, such as sorafenib, lenvatinib and bevacizumab combined with atezolizumab, have focused on angiogenesis. HIMALAYA was the first trial to demonstrate the benefit of dual immune checkpoint inhibitors, representing a new treatment option in this scenario.

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Liver cancer is the third most common cause of cancer-related mortality worldwide, with over 780,000 deaths in 2018. About 90% of liver cancer cases originate in liver cells and are referred to as hepatocellular carcinoma (HCC). Systemic treatment (medications) is the mainstay for patients with advanced disease who are not suitable for resection or liver transplant and aims to improve survival and quality of life. HIMALAYA was the first study to demonstrate the benefit of using a combination of two immunotherapy medications for initial treatment.

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The HIMALAYA study illustrates the value of the STRIDE regimen. One single dose of anti-CTLA4 tremelimumab plus durvalumab demonstrated an overall survival benefit for patients in need of first-line therapy for advanced hepatocellular carcinoma.

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Papers of special note have been highlighted as: • of interest; •• of considerable interest

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Vol. 18, No. 33

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Received 26 June 2022

Accepted 27 September 2022

Published online 18 November 2022

Published in print October 2022

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Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/fon-2022-0652

Financial & competing interests disclosure

TB de Castria received support from Astra Zeneca, Bayer, Eli Lilly, Genentech/Roche, Bristol-Myers Squibb, Merck KGaA, Merck Sharp & Dohme. JJ Harding receives research support from Bristol Myers Squib, Boehringer Ingelheim, Calithera, CytomX, Eli Lilly, Genoscience, Loxo, Novartis, Pfizer, Polaris, Yiviva and Zymeworks and consulting support from Adaptimmune, Bristol Myers Squibb, CytomX, Eli Lilly, Exelixis, Hepion, Merck, Medvir,Tempus, QED and Zymeworks. DN Khalil receives consulting fees from AbbVie and Psioxus and holds intellectual property interests related to CD40 and in situ vaccination and intellectual property rights associated with Merck Sharp & Dohme. EM O'Reilly and GK Abou-Alfa receives research support from Arcus, Astra Zeneca, BioNtech, BMS, Celgene, Flatiron, Genentech/Roche, Genoscience, Incyte, Polaris, Puma, QED, Silenseed and Yiviva and consulting support from Adicet, Alnylam, Astra Zeneca, Autem, Beigene, Berry Genomics, Boehringer Ingelheim, Celgene, Cend, CytomX, Eisai, Eli Lilly, Exelixis, Flatiron, Genentech/Roche, Genoscience, Helio, Helsinn, Incyte, Ipsen, Merck, Nerviano, Newbridge, Novartis, QED, Redhill, Rafael, Servier, Silenseed, Sobi, Vector and Yiviva. GK Abou-Alfa has a patent (PCT/US2014/031545) filed on March 24, 2014, priority application serial no.: 61/804,907; filed: March 25, 2013. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

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Tremelimumab and durvalumab in the treatment of unresectable, advanced hepatocellular carcinoma

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References