Combining radiation and an immunotherapy drug can safely and effectively treat a common but advanced liver cancer, according to results of a study by Singapore General Hospital (SGH) and National Cancer Centre Singapore (NCCS) researchers.

The study involved patients with advanced hepatocellular carcinoma, which is the third and fourth most common cause of cancer deaths among men and women in Singapore respectively. A large proportion of patients are diagnosed at a stage when their cancer can no longer be removed by surgery and treatment options are limited. This highlights an urgent need to find new ways to improve survival for patients with this disease.

Forty patients between the ages of 23 and 79 years were given immunotherapy drug nivolumab and yttrium-90 resin microspheres radioembolisation (Y90-RE), a form of internal radiation therapy. Nivolumab was given intravenously 21 days after Y90-RE was administered, and then every two weeks after. The treatment was halted when severe toxicities developed or progressed.

The study found that the participants had an overall response rate of 30.6 per cent, which rose to 43.5 per cent for those with cancer limited only to the liver. The combination therapy was also found to be safe and tolerable, the study said.

“The findings of this study augur well for advanced liver cancer patients who are faced with limited treatment options. If the efficacy of this new combination treatment is further shown in studies from other countries, it would benefit not only those in Singapore, but the region as well, given that liver cancer is a huge problem in this part of the world,” said Clinical Associate Professor David Ng, Headand Senior Consultant, Department of NuclearMedicine and Molecular Imaging, SGH.

Clinical Associate Professor David Tai, Senior Consultant, Division of Medical Oncology, NCCS, and the Principal Investigator of the study (pictured above), said, “The team’s next step is to validate these findings in a larger cohort of patients with advanced liver cancer with no distant spread.”

The findings of the study were published in The Lancet Gastroenterology and Hepatology last October.

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