Sorafenib is a long-standing treatment for metastatic liver cancer.

Although it has worked well and helped many patients with liver cancer, a long-standing limitation of treating metastatic liver cancer has been the lack of an alternative treatment for patients whose disease progresses while taking sorafenib or who cannot remain on sorafenib due to side effects.

Results from the CHECKMATE 040 phase 1/2 study, which centered on the immuno-oncology drug nivolumab, were recently published to see if adding another immuno-oncology drug, ipilimumab, to nivolumab and cabozantinib would be more effective.

Of the 71 patients, 36 received ipilimumab in addition to nivolumab and cabozantinib and 35 received nivolumab and cabozantinib alone. The results showed that patients who received the three drugs had a longer duration of response than those who received the two drugs. Progression-free survival was slightly shorter, but overall survival was longer in patients taking the three drugs. Obviously, the three-drug regimen had a higher rate of adverse events and 23% of patients eventually discontinued because of them, but early studies show promise. We look forward to seeing the results of future studies.