In previous reports, anti‐VEGF agents were able to modulate immune function and enhance T cell antitumor activity, 25 , 26 which might explain why single agents with an immune checkpoint inhibitor (ICI) such as pembrolizumab and nivolumab failed to reach statistical significance, 27 , 28 while combining an anti‐VEGF agent with ICI improved clinical outcomes significantly. 10 This points to the immunomodulator effect of the anti‐VEGF agents.
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Factors predictive of clinical outcome in advanced hepatocellular carcinoma patients receiving ramucirumab treatment: A real-world experience.
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In subgroup analysis of the REACH trial, 3 patients with higher AFP levels showed better survival outcomes, although the trial did not reach statistical significance.