COSMIC-312: mounting immunotherapy enigmas for hepatocellular carcinoma

COSMIC-312 1 Kelley RK Rimassa L Cheng AL et al. Cabozantinib plus atezolizumab versus sorafenib for advanced hepatocellular carcinoma (COSMIC-312): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2022; 23: 995-1008 Summary Full Text Full Text PDF PubMed Scopus (19) Google Scholar is the first phase 3 randomised controlled trial (RCT) to assess the efficacy of a tyrosine–kinase inhibitor-based immunotherapy doublet as first-line systemic treatment for advanced hepatocellular carcinoma. Despite achieving significantly longer median progression-free survival than sorafenib (6·8 months [99% CI 5·6–8·3] vs 4·2 months [2·8–7·0]), cabozantinib plus atezolizumab did not show improvement in median overall survival at the first interim analysis (15·4 months [96% CI 13·7–17·7] for cabozantinib plus atezolizumab vs 15·5 months [12·1–not estimable] for sorafenib). Cabozantinib plus atezolizumab versus sorafenib for advanced hepatocellular carcinoma (COSMIC-312): a multicentre, open-label, randomised, phase 3 trialCabozantinib plus atezolizumab might be a treatment option for select patients with advanced hepatocellular carcinoma, but additional studies are needed. Full-Text PDF Open Access