Measuring the change in elasticity and size of tumors in hepatocellular carcinoma (HCC) from biopsy at baseline to biopsy/resection after 6 weeks of treatment with immune checkpoint inhibitors (ICIs) may be a good indicator of response to these therapies, according to the results of a small prospective study. These findings were presented in a poster during the 2020 Gastrointestinal Cancer Symposium in San Francisco, California.

The study included 25 evaluable nonsurgical and surgical patients with HCC who had undergone liver magnetic resonance imaging (MRI) and magnetic resonance elastography (MRE) and HCC biopsy at baseline. Surgical patients were treated with nivolumab alone or nivolumab and ipilimumab, and nonsurgical patients were treated with pembrolizumab. Following 6 weeks of immunotherapy treatment, all patients underwent a second biopsy and MRI/MRE.

Treatment response in surgical patients was defined as less than 50% viable tumor at the time of resection, and response in nonsurgical patients was determined by overall survival of more than 1 year after treatment initiation. Of the included patients, 8 had nonalcoholic steatohepatitis (NASH), 8 had hepatitis C virus, 8 had hepatitis B virus, and the remaining 7 patients had unknown etiology of liver disease.

Response to treatment was seen in 11 of 25 participants (44%). Across all patients, median HCC tumor size was 4.7 cm (range, 1.2-14.0), and change in size was -0.32 cm. Median baseline tumor stiffness and change in stiffness were 5 kPa and -0.1 kPa, respectively.

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The median change in tumor size for responders and nonresponders was -1.2 cm (range, -4.8 to 0.4) and 0 cm (range, -1.5 to 1.1), respectively, which was deemed a statistically significant difference (P =.02). In addition, response to treatment was characterized by an increase in tumor stiffness (P <.001) and the lack of portal venous phase capsular enhancement on MRI.

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In summary, the authors wrote that “Capsular enhancement and MRE stiffness change may be useful biomarkers of immune cell-activated response to [immune checkpoint blockade] therapy.”

Disclosure: Some of the authors disclosed financial relationships with pharmaceutical or medical device companies. For a full list of disclosures, please refer to the original abstract.


Qayyum A, Avritscher R, Aslam R, et al. Immune checkpoint blockade (ICB) response evaluation with MRI/MR elastography (MRE) in surgical and nonsurgical patients with HCC. J Clin Oncol. 2020;38(suppl 4):Abstract 480.

This article originally appeared on Cancer Therapy Advisor