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Using dual checkpoint blockade to treat fibrolamellar hepatocellular carcinoma
  1. Enrico N De Toni,
  2. Daniel Roessler
  1. Department of Medicine II, University Hospital, LMU Munich, Munich, Germany
  1. Correspondence to Dr Enrico N De Toni, Department of Internal Medicine II, University of Munich, Munich 81377, Germany; enrico.detoni{at}

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We have read with interest the paper by Gerbes et al,1 which highlights the current developments in the treatment of hepatocellular carcinoma (HCC). Fibrolamellar HCC (FL-HCC) is, in contrast to HCC,2 an infrequent tumour, most often occurring in adolescents or young adults without underlying liver disease.3 Chemotherapy-based regimens are typically used to treat FL-HCC based on studies in small patients’ cohorts and case series.3 Despite anecdotal reports of response to systemic treatment, the prognosis of advanced FL-HCC is poor.4

The development of immune checkpoint inhibitors (ICP) is drastically changing the approach to the treatment of HCC. In particular, recent trials showed that immunoncological treatment can be potentiated if ICP are used in combination.5 6 This is exemplified by the use of nivolumab/ipilimumab,7 and by the results of the phase III IMBRAVE 150 trial, which recently marked …

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  • Contributors ENDT and DR conceived and drafted the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests ENDT has served as a paid consultant for AstraZeneca, Bayer, BMS, EISAI, Eli Lilly & Co, Pfizer, IPSEN and Roche. He has received reimbursement of meeting attendance fees and travel expenses from Arqule, BMS, Bayer, Celsion and Roche, and lecture honoraria from BMS and Falk. He has received third-party funding for scientific research from Arqule, AstraZeneca, BMS, Bayer, Eli Lilly and Roche. DR has received reimbursement of meeting attendance fees and travel expenses from Celsion and IPSEN.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.