Safety and Efficacy of Durvalumab Plus Tremelimumab in Older Individuals With Unresectable Hepatocellular Carcinoma: A Multicenter Analysis

Aim To evaluate the safety and efficacy of durvalumab plus tremelimumab (Dur/Tre) in older adults with unresectable hepatocellular carcinoma (HCC). Methods A total of 345 patients with HCC who received Dur/Tre were included in this study. Using propensity score matching, we compared outcomes between older (aged ≥ 75 years; n = 120) and younger individuals ( n = 120). Results The median progression‐free survival (PFS) was 3.3 months in the older group and 4.5 months in the younger group ( p = 0.271). The median overall survival (OS) was 17.0 months in older individuals and 19.2 months in younger individuals ( p = 0.598). No statistically significant differences were observed in the therapeutic response between the two groups ( p = 0.264). Additionally, the incidence of immune‐mediated adverse events (AEs) did not differ significantly between older and younger individuals. Multivariate analyses revealed that age group (older vs. younger) was not an independent prognostic factor for PFS ( p = 0.250) or OS ( p = 0.489). In a subgroup analysis stratifying older individuals into three age categories (75–79, 80–84, and ≥ 85 years), no significant differences were observed in the cumulative OS or PFS across the subgroups ( p = 0.308 and 0.783). Similarly, the incidence of immune‐mediated AEs did not differ significantly among the age categories. Conclusions Dur/Tre appears to be a safe and effective treatment option for patients with HCC, regardless of age. Dur/Tre appears to be a safe and effective treatment option for patients with unresectable HCC, regardless of age.