HCC

Panelists discuss how emerging evidence suggests that combining transarterial chemoembolization (TACE) with systemic therapy could redefine the standard of care for hepatocellular carcinoma (HCC). Trial outcomes may drive shifts toward more personalized locoregional approaches. However, challenges in implementation include optimizing patient selection, managing toxicity, and ensuring multidisciplinary coordination.

Panelists discuss how the role of systemic therapy in intermediate-stage hepatocellular carcinoma (HCC) is evolving with combinations like immunotherapy and targeted agents enhancing locoregional treatment. LEAP-012 and EMERALD-1 evaluate lenvatinib + pembrolizumab and durvalumab-based regimens with transarterial chemoembolization (TACE), respectively. Their findings may redefine treatment paradigms, improving outcomes and expanding therapeutic options.

A global, randomized, phase 1b/2 trial is evaluating IO-108 in patients with metastatic and/or unresectable hepatocellular carcinoma.

The panelist discusses first-line options including atezolizumab plus bevacizumab, lenvatinib, and sorafenib. Second-line treatments include regorafenib, cabozantinib, and ramucirumab. Clinical trials should be prioritized when available.

The panelist discusses the case of a 60-year-old man diagnosed with unresectable hepatocellular carcinoma (HCC). The patient has a history of metabolic dysfunction-associated steatohepatitis managed with lifestyle changes and medication. Initially, there was no clinical or radiographic evidence of cirrhosis. The patient recently presented to his gastroenterologist complaining of abdominal pain in the upper right quadrant and fatigue.

Amezalpat received fast track designation from the FDA for the treatment of patients with hepatocellular carcinoma.

The CheckMate 9DW study demonstrated the efficacy and manageable safety of first-line nivolumab plus ipilimumab in patients with unresectable hepatocellular carcinoma.

TACE with camrelizumab and rivoceranib significantly improves PFS in unresectable HCC, per phase 2 CARES-005 study results.

The FDA granted orphan drug designation to amezalpat in hepatocellular carcinoma based on phase 1b/2 data showing efficacy and safety with atezolizumab and bevacizumab in frontline treatment.

During a Case-Based Roundtable® event, Pierre Gholam, MD, discussed how post hoc and real-world analyses build upon the limited available trial data for treating patients with unresectable hepatocellular carcinoma with Child-Pugh B status.

The FDA approved a phase 3 trial to assess amezalpat with the current standard of care in unresectable or metastatic hepatocellular carcinoma.

The new drug application resubmission of rivoceranib/camrelizumab in the first line in unresectable or metastatic hepatocellular carcinoma is supported by the final survival analysis of CARES-310 trial.

A new drug application has been resubmitted to the FDA for the combination of camrelizumab and rivoceranib as a first-line treatment for unresectable hepatocellular carcinoma, following a complete response letter in May 2024.

The HIMALAYA study showed that the combination of tremelimumab and durvalumab significantly improved overall survival in patients with hepatocellular carcinoma.

A combination of lenvatinib, pembrolizumab, and TACE significantly improved progression-free survival in patients with intermediate-stage hepatocellular carcinoma compared to dual placebo and TACE.

The application is supported by the phase 3 CheckMate -9DW study, and the FDA has set a target action date of April 21, 2025.

During a Case-Based Roundtable® event, Pierre Gholam moderated a discussion on how to proceed with a patient presenting with a LI-RADS 5 mass suspected of being hepatocellular carcinoma.

The FDA has given positive feedback on the planned phase 3 study for the combination of amezalpat, atezolizumab, and bevacizumab in the first-line treatment of unresectable or metastatic hepatocellular carcinoma.

A phase 1 trial is evaluating treatment with MT-303 in patients with hepatocellular carcinoma to determine its safety, pharmacokinetics, pharmacodynamics, and preliminary efficacy.

Stacey Stein, MD, discusses the patient population and outcomes of the IMbrave150 trial of atezolizumab plus bevacizumab for patients with advanced hepatocellular carcinoma.

With extended follow-up, the combination of investigational agents rivoceranib and camrelizumab demonstrated a significant survival benefit vs sorafenib in advanced, unresectable hepatocellular carcinoma.

The combination of camrelizumab and rivoceranib significantly improved survival rates in patients with unresectable liver cancer compared with standard treatment.

Stacey Stein, MD, discusses the background and outcomes of the IMbrave150 trial of atezolizumab plus bevacizumab in patients with advanced hepatocellular carcinoma.

During a live Community Case Forum event in partnership with the Tennessee Oncology Practice Society, Pierre Gholam, MD, examined the current state of treatment for patients with hepatocellular carcinoma, looking in particular at what data is available for those with Child-Pugh B and C status who have poorer outcomes and have limited data from prospective clinical trials.

In a retrospective study in patients with hepatocellular carcinoma, 40% of patients developed irAEs after receiving the first and second doses of immunotherapy.