Al B. Benson, MD

Al B. Benson, MD, professor of Medicine, Hematology and Oncology, Northwestern University Feinberg School of Medicine, discusses concerns in the hepatocellular carcinoma (HCC) setting for treating patients for the best outcomes.

Benson says patients with HCC have complex disease, particularly because of the possible comorbidities. Much of the research in this setting has been for those with Child-Pugh A disease. Many patients with HCC have more severe cirrhosis, with Child-Pugh B or C disease, and it is important to find out if the treatment options being investigated in HCC work as well for these patients as they do in those with Child-Pugh A disease. This is mainly in terms of the overall performance status and tolerability of the therapy. He feels there are challenges with patient selection for the best therapeutic options.

Multidisciplinary determination of disease is critical, according to Benson. There are also issues when it comes to transplantation being delayed for patients with HCC while they wait for a liver to be available. The best management for those patients, whether it is bridge therapy or other approaches to keep patient’s disease stable while they wait for their transplant, is still being debated.

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Al B. Benson, MD, discusses concerns in the hepatocellular carcinoma setting for treating patients for the best outcomes.

Challenges When Treating Patients With Hepatocellular Carcinoma

Al B. Benson, MD, professor of Medicine, Hematology and Oncology, Northwestern University Feinberg School of Medicine, discusses recent developments for the treatment of patient with hepatocellular carcinoma (HCC) with systemic therapy in the first and second line.

Benson says it’s important to determine when a patient with HCC would do best with a systemic therapy rather than a liver-targeted therapy. Recently, there have been many advances in this setting. Patients used to only have single-agent sorafenib (Nexavar) as an option, but now there are multiple kinds of approaches in the first and second line. This includes lenvatinib (Lenvima) in the first line and regorafenib (Stivargo), nivolumab (Opdivo), pembrolizumab (Keytruda), and cabozantinib (Cabometyx) as second-line therapies.

Additionally, immunotherapy has become a topic of interest for these patients according to Benson. The combination of atezolizumab (Tecentriq) plus bevacizumab (Avastin) is now FDA-approved as a treatment for patients with unresectable or metastatic HCC who have not received systemic therapy before. This was based on the IMbrave150 trial (NCT03434379).

Al B. Benson, MD, discusses recent developments for the treatment of patient with hepatocellular carcinoma with systemic therapy in the first and second line.

Al B. Benson, MD | Authors

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Challenges When Treating Patients With Hepatocellular Carcinoma

Systemic Therapy Advances Provide More Treatment Options in HCC