Clinical utility of immunotherapy hyperprogressive genes in hepatocellular carcinoma patients.

e16126 Background: Hepatocellular carcinoma (HCC) is the most common liver malignancy associated with poor prognosis. With the rapid development of systematic therapy for liver cancer, immunotherapy has been widely used in therapy of liver cancer. Hyperprogression of tumor is a phenomenon of accelerated tumor growth, which occurs in patients with liver cancer and other solid tumors receiving systematic treatment, and is mainly related to immunotherapy hyperprogression genes. However, it is still unclear about the genes of immune hyperprogression in HCC patients. Therefore, we studied the molecular characteristics of HCC patients, including the genes related to immunotherapy hyperprogression. Methods: From June 2019 to August 2021, 102 patients with HCC were inculded in this study. Matched tumor/normal DNA from HCC patients (N = 102) were analyzed by whole exome sequencing (WES) or Acornmed panel with 808 cancer-related genes. Results: Overall, 86.3% (88/102) patients exhibited genetic alterations. TP53 (50%), TERT (23%), CTNNB1 (18%) and KMT2C (14%) were the most commonly mutated genes in HCC. In addition, 8.9% patinets harbored at least one immunotherapy hyperprogressive gene mutations, including CCND1 (7%), FGF19 (6%), FGF3 (5%), FGF4 (5%) and MDM4 (2%). In addition, CCND1 and FGF19 were frequently mutated genes in patients with liver cancer, ranking ninth and tenth, respectively. Compared with the TCGA data, there was no significant difference in immunotherapy hyperprogressive genes (25% vs 32.3%, p = 0.18). Interesting, CCND1, FGF19, FGF3 and FGF4 mutations occurred simultaneously in most patients and were mutually exclusive with MDM4 (p = 0.057). Conclusions: This study contributes to understand the molecular characteristics of patients with HCC, which will be useful to guide immunotherapy and promote the clinical management in this population. Furthermore, the study suggested that both Chinese and Western populations should pay attention to immunotherapy hyperprogression genes in immunotherapy selection.