First-Line Durvalumab–Tremelimumab in Advanced Hepatocellular Carcinoma: Real-World Data from Turkey
Mustafa Murat Mıdık, Gökhan Şahin, Bekir Mert Durukan, Fatih Kuş, Kübra Haşimoğlu Gürün, Sinan Ünal, Cem Mirili, Canan Karan, Engin Hendem, Teoman Şakalar, Miray Aydoğan, Bahadır Köylü, Nadiye Sever, Bahattin Engin Kaya, Tülay Kuş, Canberk Şencan, Atike Pınar Erdoğan, Hatime Arzu Yaşar, Hilal Karakaş, Oğuzhan Yıldız, Bahiddin Yılmaz, Murat Alan, Bülent Çetin, Nedim Turan, Melek Karakurt Eryılmaz, Mehmet Artaç, İlkay Tuğba Ünek, Fatih Selçukbiricik, Mehmet Ali Şendur, Hasan Çağrı Yıldırım, Şuayib YalçınBackground: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. Although the STRIDE regimen (durvalumab plus tremelimumab) has demonstrated an overall survival benefit in clinical trials, real-world evidence remains limited, particularly in Turkish clinical practice. This study aimed to evaluate the effectiveness and safety of first-line STRIDE therapy in patients with unresectable HCC treated in routine clinical practice. Methods: We conducted a retrospective multicenter study including patients with unresectable HCC who received first-line durvalumab plus tremelimumab through the Turkish national Early Access Program across 18 oncology centers. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method, and exploratory Cox regression analyses were performed to evaluate baseline prognostic factors. Results: Thirty-two patients were included. The median PFS was 7.25 months (95% CI, 3.68–22.29), and the median OS was 11.43 months (95% CI, 4.50–not reached). The underlying liver disease etiology was non-viral in 53.1% of patients, hepatitis B virus in 40.6%, and hepatitis C virus in 6.3%. Grade ≥ 3 treatment-related adverse events occurred in fewer than 10% of patients. Conclusions: In this multicenter real-world cohort, first-line durvalumab plus tremelimumab appeared to be a feasible treatment option and was generally well tolerated in patients with unresectable HCC. However, given the retrospective design, small sample size, and absence of a control group, these findings should be interpreted cautiously and require confirmation in larger prospective comparative studies.