Adding a Novel Agent to Standard of Care May Improve Survival in Liver Cancer

Adding TPST-1120 to Tecentriq and Avastin tended to improve outcomes for patients with hepatocellular carcinoma, research showed.

The addition of a novel peroxisome proliferator-activated receptor antagonist to firstline treatment with Tecentriq (atezolizumab) and Avastin (bevacizumab) may improve survival compared with a Tecentriq-Avastin combination in patients with unresectable or metastatic hepatocellular carcinoma (HCC), a type of liver cancer.

This triplet therapy was compared with the combination therapy in a phase 1b/2 clinical study, in which researchers announced updated positive results, according to a press release from Tempest Therapeutics, the manufacturer of the novel agent, TPST-1120.

In the study, researchers compared outcomes from 40 patients with unresectable or metastatic HCC who were treated with TPST-1120, Tecentriq and Avastin compared with 30 patients treated with Tecentriq plus Avastin. Of note, Tecentriq plus Avastin is considered standard of care for this patient population.

The confirmed objective response rate, defined as the percentage of patients with a partial or complete response to treatment, was 30% for the triplet-therapy group compared with 13.3% in the combination therapy group, according to the release. The duration of response, which refers to how long a patient’s disease responds to treatment, was not reached in this study, meaning that more than half of patients continued to respond to treatment when this end point was assessed.

The median progression-free survival (the time during and after treatment when a patient with cancer is alive without disease worsening) in patients treated with TPST-1120, Tecentriq and Avastin was seven months compared with 4.27 months in patients treated with Tecentriq plus Avastin. The press release noted that the data for this end point were not mature, meaning that researchers have not yet collected and analyzed enough data to draw a definitive conclusion around this outcome.

Data for overall survival (the time from treatment assignment when a patient with cancer is still alive) were also not mature, although at the time of reporting, it favored the triplet therapy group compared with the combination therapy group, according to the release. Overall survival was not reached for the triplet therapy group compared with 15.1 months in the combination therapy group.

“This comprehensive analysis of more mature clinical data shows an even greater benefit than the earlier interim analysis of the TPST-1120 triplet therapy over standard of care alone, both for the entire population and in subpopulations of patients, the latter of which was predicted by TPST-1120’s proposed mechanism of action,” Stephen Brady, president and chief executive officer of Tempest Therapeutics, said in the release. “First-line HCC remains an indication with substantial opportunity to improve patient outcomes, and, based upon these data, we are excited about the opportunity to move TPST-1120 into a pivotal study.

According to the World Health Organization, HCC is an aggressive type of cancer that affects the liver, with an estimated 900,000 patients worldwide receiving this diagnosis ever year. The release noted that approximately 70% to 80% of patients with early-stage HCC may experience disease recurrence after surgery despite being diagnosed early. Factors that may increase the risk of disease recurrence include the number of tumors, tumor size and portal vein invasion, which refers to a blood vessel that carries blood to the liver from organs like the spleen, intestines, gallbladder and pancreas.

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