Perioperative Nivolumab Combined with Irreversible Electroporation Shows Antitumoral Effect in High-Risk BCLC A Hepatocellular Carcinoma: Results from the NIVOLEP Phase 2 Trial

Highlights

The NIVOLEP trial represents a significant advancement in the multimodal treatment of hepatocellular carcinoma. Neoadjuvant and adjuvant nivolumab combined with irreversible electroporation achieved a one-year local recurrence-free survival rate of 70.6% in patients with BCLC A HCC at high risk of recurrence. Pathological response rates reached 26.3% following neoadjuvant immunotherapy, with RNA sequencing confirming robust immune activation within the tumor microenvironment. The combination approach demonstrates acceptable safety with grade 3-4 adverse events occurring in only 2 patients, though one treatment-related mortality was observed. These findings suggest that perioperative immunotherapy may enhance the efficacy of ablation-based treatment strategies in liver cancer.

Background