Outcomes with Single Tremelimumab Regular Interval Durvalumab (STRIDE) for Unresectable Hepatocellular Carcinoma in the US Veterans Administration

Background: HIMALAYA demonstrated that STRIDE (Single Tremelimumab Regular Interval Durvalumab) significantly improved overall survival (OS) compared with sorafenib in participants with unresectable hepatocellular carcinoma (HCC). This retrospective, real-world cohort study evaluated outcomes with STRIDE in veterans with HCC. Methods: Patients diagnosed with HCC between 1 January 2008 and 28 February 2024 who received ≥1 dose of STRIDE for unresectable disease were included. Data were collected from the Veteran Affairs Corporate Data Warehouse. Safety and efficacy were evaluated overall and for subgroups of patients with Child–Pugh A versus Child–Pugh B cirrhosis, viral versus non-viral HCC, and those with versus without prior non-systemic therapies. Results: Overall, 107 patients (100.0% male) were included. Median (interquartile range) age was 72.2 (68.0–76.1) years. There were 22 Grade 3–4 adverse events reported (three in patients with Child–Pugh B cirrhosis). Median OS (95% CI) was 12.4 (9.1–22.1) months and 5.2 (1.5–9.3) months in patients with Child–Pugh A (n = 81; 75.7%) and Child–Pugh B cirrhosis (n = 26; 24.3%), respectively. In patients with viral (n = 64; 59.8%) versus non-viral etiology (n = 43; 40.2%), median OS (95% CI) was 10.5 (7.0–25.6) months versus 9.0 (4.6–16.0) months, respectively. In patients without (n = 30; 28.0%) versus with prior non-systemic therapies (n = 77; 72.0%), median OS (95% CI) was 7.7 (2.8–17.3) months versus 11.1 (7.6–17.6) months, respectively. Conclusions: These results suggest that STRIDE is well tolerated and may offer a survival benefit to a broad range of patients with unresectable HCC, representing populations that are more reflective of real-world clinical practice.