Richard Finn, MD

Richard S. Finn, MD, an assistant professor of clinical medicine at the Geffen School of Medicine at the University of California, Los Angeles (UCLA), and director of the Signal Transduction and Therapeutics Program at the Jonsson Comprehensive Cancer Center at UCLA, discusses how he sees the field of hepatocellular carcinoma (HCC) evolving in the future.

When he was asked the same question in 2007 when sorafenib (Nexavar) was approved, he said he believed we were going to see so much activity in HCC. However, he notes that this prediction may not have been perfect because it took a long time to get another drug approved after that.

There has since been a burst of data, including findings from the IMbrave150 trial, which Finn says has launched the field of HCC forward dramatically. He believes we may see more triplet regimens or agents with totally different mechanisms of action in the HCC space.

We need to take the time to think about that carefully rather than empirically adding agents and getting negative data, says Finn. Moving these highly effective novel therapies and regimens into earlier lines of therapy for HCC will have the biggest impact. Finn hopes that doing so will increase cure rates after surgery or chemoembolization.

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Richard S. Finn, MD, discusses how he sees the field of hepatocellular carcinoma evolving in the future.

Exploring the Future Treatment Landscape of Hepatocellular Carcinoma

Richard Finn, MD, Division of Hematology/Oncology at the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, discusses the difficulties of treating liver cancer.

Finn says liver cancer is unique because it occurs with underlying liver disease and cirrhosis. Many drugs in this space have ignored underlying liver disease with the exception of sorafenib, which was the last liver cancer drug to be approved.

Sorafenib continues to be the standard when treating liver cancer because it was developed to minimize the effect of underlying liver disease. In the SHARP trial, Finn says, sorafenib improved the survival rate of patients with liver cancer compared to a placebo.

Since the SHARP trial, there have been many more phase III studies, but no new drugs have demonstrated superiority to sorafenib, Finn says.

Finn thinks that many antiangiogenic multikinase inhibitors could have shown benefit compared with placebo in frontline studies, but as sorafenib is the standard, it has been difficult to improve upon.

Liver cancer is unique because it occurs with underlying liver disease and cirrhosis

Sorafenib was the last liver cancer drug to be approved

Sorafenib continues to be the medical standard when treating liver cancer because it minimizes the effect of underlying liver disease in patients

No drugs have demonstrated superiority to sorafenib over the last several years

Richard Finn, MD, from UCLA's Jonsson Comprehensive Cancer Center, discusses the difficulties of treating liver cancer.

The Challenges of Treating Liver Cancer

Richard Finn, MD, Division of Hematology/Oncology at the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, discusses the treatment of patients with estrogen receptor-positive (ER+) breast cancer with antiestrogens.

12th International Congress on the Future of Breast Cancer

from July 18-20, 2013, in Huntington Beach, CA, Finn discussed novel therapies for virulent ER+ disease.

It is the general understanding that ER+ breast cancer behaves well, Finn says. ER+ disease has more treatment options compared to other types of breast cancer because it is dependent on estrogen receptor signaling, which can be modulated in several different ways.

In clinical practice, a physician can get a sense of how a patient will do based on their response to antiestrogens. There is a group of patients with ER+ disease that do not do well, Finn says, and will have a rapid progressive course and no disease control.

The challenge remains to incorporate what is known about the molecular makeup of this population into clinical utility.

ER+ breast cancer typically behaves well and has several treatment options

Some patients with ER+ disease do not do well when treated with antiestrogens

The challenge remains to incorporate what is known about the molecular makeup of this group into clinical utility

Richard Finn, MD, from UCLA, discusses the treatment of patients with estrogen receptor-positive (ER+) breast cancer with antiestrogens.

Treating ER+ Breast Cancer Patients With Antiestrogens

Richard Finn, MD, Division of Hematology/Oncology at the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, describes the development of cyclin-dependent kinases (CDKs) for the treatment of cancer.

The inhibition of CDKs is a somewhat new approach to the treatment of cancer, Finn says, even though the biology has been known for a long time. For well over a decade, Finn continues, drugs have been developed aimed at targeting CDKs, though none have found a home in cancer management.

CDKs play a key role in regulating cell cycle progression and at least nine have been identified. CDKs may play an important role in the treatment of breast cancer, Finn says, but also to the entire field of oncology.

Inhibition of CDKs is a new approach to treating cancer, though the biology has been known for a long time

CDKs play a key role in regulating cell cycle progression

Richard Finn, MD, from the Jonsson Comprehensive Cancer Center, UCLA, describes the development of cyclin-dependent kinases (CDKs) for the treatment of cancer.

Cyclin-Dependent Kinases and the Treatment of Cancer

Richard Finn, MD, Division of Hematology/Oncology at the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, comments on the future of palbociclib (PD 0332991), a novel oral selective inhibitor of cyclin-dependent kinase 4/6 (CDK 4/6), for the treatment of breast cancer.

Currently, palbociclib is the lead indication in patients with ER-positive breast cancer, Finn says, and could become a practice-changing agent.

If the magnitude of progression-free survival benefit seen in the phase II study of this agent is seen in the phase III study, palbociclib will become the standard of care for first-line ER-positive disease, Finn notes. Palbociclib is well-tolerated, as is any anti-endocrine therapy.

If the efficacy of palbociclib can be improved without a significant increase in toxicity, the door for palbociclib would be open to other settings, Finn says. Palbociclib could be evaluated in other lines of therapy and other subtypes of breast cancer. The ultimate objective, Finn says, is to get palbociclib to early-stage disease.

Finn believes palbociclib will be a practice-changing agent for the treatment of ER-positive breast cancer

Palbociclib demonstrated benefit to progression-free survival in this population compared with letrozole

In the future, palbociclib could move to other lines of therapy and subtypes of breast cancer

View all coverage from the 2013 ASCO Meeting

Richard Finn, MD, comments on the future of palbociclib (PD 0332991), a novel oral selective inhibitor of cyclin-dependent kinase 4/6 (CDK 4/6), for the treatment of breast cancer.

Richard Finn, MD | Authors

Articles

Exploring the Future Treatment Landscape of Hepatocellular Carcinoma

The Challenges of Treating Liver Cancer

Treating ER+ Breast Cancer Patients With Antiestrogens

Cyclin-Dependent Kinases and the Treatment of Cancer

The Future of Palbociclib for the Treatment of Breast Cancer