{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T08:49:09Z","timestamp":1766134149698,"version":"3.41.2"},"reference-count":16,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> Immune checkpoint inhibitors (ICIs) is the initial line of management in advanced hepatocellular carcinoma (HCC), but survivals in the real world are not known. <\/jats:p><\/jats:sec><jats:sec><jats:title>MATERIALS AND METHODS<\/jats:title><jats:p> A retrospective study of patients with advanced HCC receiving ICIs (as first-line therapy or as later lines of therapy) across 11 Indian institutions was conducted. Patients were divided into either cohort 1 (trial-like receiving ICI as first-line therapy), with a Child Pugh score (CTP) of \u22646, an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0\/1, and no VP4 (main portal vein thrombosis [MPVT]) or cohort 2 (trial unlike) who did not satisfy at least one of the above criteria. The primary end point was 12-month overall survival (OS). <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> Between January 2017 and January 2022, 133 patient data were analyzed. The presence of MPVT was seen in 33 patients (25%). The ICIs used were atezolizumab-bevacizumab, nivolumab, and pembrolizumab in 89 (66%), 44 (33%), and one (1%) patients, respectively. With a median follow-up of 13.8 months, the 12-month OS for the entire cohort was 33.4% (95% CI, 23.6 to 43.2). Patients in cohort 1 (n = 31) had a significantly improved OS compared with patients in cohort 2 (n = 102; 12-month OS, 57.9% [95% CI, 38.5 to 77.3] v 24% [95% CI, 13.4 to 34.6]; P = .005). Patients with CTP A as compared with CTP B (9.7 v 4.3 months; P &lt; .001) and an ECOG PS of 0\/1 as compared with a PS of \u22652 (8.7 v 7.2 months; P = .04) and without MPVT (9.4 v 4.0; P &lt; .001) had superior survivals. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> Patients with advanced HCC in the real world, trial-like have survivals in consonance with trial data, whereas patients with features excluding them from trials, such as main portal vein thrombosis, poor ECOG PS, and child Pugh B status, have markedly inferior survivals, despite good tolerance to immunotherapy. <\/jats:p><\/jats:sec>","DOI":"10.1200\/go.23.00215","type":"journal-article","created":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T20:59:21Z","timestamp":1701377961000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":4,"title":["Survival of Trial-Like and Non\u2013Trial-Like Patients With Immunotherapy in Advanced Hepatocellular Carcinoma in Real World: A Collaborative Multicenter Indian Study (IMHEP)"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8169-4264","authenticated-orcid":true,"given":"Anant","family":"Ramaswamy","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Parel, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1240-1675","authenticated-orcid":true,"given":"Anand","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Gachibowli, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"John","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Parel, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6360-3349","authenticated-orcid":true,"given":"Amit","family":"Rauthan","sequence":"additional","affiliation":[{"name":"Manipal Hospital, Bangalore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shekhar","family":"Patil","sequence":"additional","affiliation":[{"name":"HCG Group of Hospital, Bangalore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3590-2664","authenticated-orcid":true,"given":"Ajay","family":"Duseja","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9149-6969","authenticated-orcid":true,"given":"Vineet","family":"Talwar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Senthil J.","family":"Rajappa","sequence":"additional","affiliation":[{"name":"Basavatarakam Indo American Cancer Hospital & RI, Banjara Hills, Hyderabad, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Ghadyalpatil","sequence":"additional","affiliation":[{"name":"Yashoda Hospital, Hyderabad, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manav","family":"Wadhawan","sequence":"additional","affiliation":[{"name":"Gastroenterology & Hepatology, Dr B. 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Kapur Memorial Hospital, (A Unit of Lahore Hospital Society), New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akash","family":"Shukla","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Seth GSMC & KEM Hospital, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7220-2689","authenticated-orcid":true,"given":"Vamshi M.","family":"Krishna","sequence":"additional","affiliation":[{"name":"Medical Oncology and Hematology, Institute of Oncology AIG Hospitals, Hyderabad, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9981-364X","authenticated-orcid":true,"given":"Sujay","family":"Srinivas","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Parel, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3901-6969","authenticated-orcid":true,"given":"Sunil","family":"Taneja","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Parel, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. 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