"For almost 10 years, sorafenib was the only approved drug in advanced liver cancer and there were no other treatment options after failure of sorafenib … Now, with nivolumab, we finally have and alternative effective and tolerable option that is changing the prognosis in liver cancer,"said Dr Choo Su-Pin, co-author of the study.

The National Cancer Centre Singapore (NCCS), together with institutions from 10 other countries, conducted a trial to assess the efficacy and safety of immunotherapy drug nivolumab in patients with advanced liver cancer or hepatocellular carcinoma (HCC).

Results from the study showed promising results: nivolumab improves survival, has a manageable safety profile and acceptable tolerability among patients.

"For almost 10 years, sorafenib was the only approved drug in advanced liver cancer and there were no other treatment options after failure of sorafenib. This was despite many trials conducted in liver cancer, all of which failed to show survival benefit.

"Now, with nivolumab, we finally have and alternative effective and tolerable option that is changing the prognosis in liver cancer," said Dr Choo Su-Pin, co-author of the study.

Nivolumab works by enhancing the body's immune response against cancer cells. It has previously been approved for treatment of several other types of cancers, including melanoma, non-small cell lung cancer and kidney cancers.

According to Dr Choo, who is a Senior Consultant Medical Oncologist and Chief of Gastrointestinal Oncology at NCCS, the drug may not work for every patient, but when it does, "The durability of response is particularly impressive.

The study was published in The Lancet in April 2017. It led to the US FDA granting accelerated approval to nivolumab for treatment of patients with advanced HCC who have previously received sorafenib on 22 September 2017.

The team has moved on with a phase-3 trial to compare the effectiveness of nivolumab with sorafenib as first-line treatment in patients with advanced HCC. The study is sponsored by Bristol-Myers Squibb and is expected to complete in October 2018.  

"We have patients who were told that they had only six months to live and they are now still very well and alive with minimal cancer after more than two years, because of this drug."