Long-term outcomes of unresectable locally advanced hepatocellular carcinoma after complete response to locoregional therapy plus immunotherapy

Previous studies showed that up to 50% of patients with untresectable locally advanced hepatocellular carcinoma (LA HCC) achieved complete remission (CR) after combined locoregional therapy (LRT) plus immunotherapy (IO). However, data on predictors of CR and long-term clinical outcomes without surgery and after discontinuation of IO are lacking. Pooled analysis of two prospective trials at the University of Hong Kong included patients with LA HCC who received SBRT and anti-PD-(L)1 therapy. LRT-IO induced radiologic CR in 46% of patients. Patients with CR were placed on a watch-and-wait protocol. 76% of these patients were alive at 3 years. The authors conclude that watch-and-wait may be a feasible strategy in patients with unresectable LA HCC who have achieved CR after LRT-IO.