Ronan W. Hsieh, MD, presents the CheckMate 9DW trial for Team Chicago Hot Dog, reviewing the phase 3 study of nivolumab plus ipilimumab versus investigator’s choice of lenvatinib or sorafenib in first-line unresectable hepatocellular carcinoma (HCC). Hsieh describes the global trial, the eligibility criteria including Child-Pugh score 5 or 6, and the exclusion of main portal vein invasion. He reviews the statistically significant improvement in median overall survival with nivolumab plus ipilimumab and the notably higher objective response and complete response rates. Hsieh highlights the early curve crossing within the first 6 months, with more treatment-related deaths in the combination arm, and presents the 4-year follow-up showing a preserved survival tail and durable responses. He details the safety profile, including immune-mediated hepatitis with a median onset of 6 weeks and frequent high-dose steroid use, noting that early hepatic adverse events drove much of the early mortality in advanced HCC.
