HCC

Unresectable HCC with Extrahepatic Involvement

Results from the phase I/II CheckMate 040 study demonstrated that single-agent nivolumab showed promising clinical activity in patients with Child-Pugh B advanced hepatocellular carcinoma, a population often excluded from advanced HCC trials.

Ghassan Abou-Alfa, MD, discusses the approved agents available for the treatment of hepatocellular carcinoma. Compared to 2007 when there was only 1 agent available, sorafenib, there is now a great number of options for these patients.

Pembrolizumab (Keytruda) has received an accelerated approval from the FDA for the treatment of patients with hepatocellular carcinoma who have previously received sorafenib (Nexavar).

Combining atezolizumab (Tecentriq) with bevacizumab (Avastin) induced promising and durable antitumor activity in patients with advanced hepatocellular carcinoma, according to findings from a phase Ib study presented during the 2018 ESMO Congress.

Kabir Mody, MD, discusses the evolution of the hepatocellular carcinoma treatment landscape over the past year during a presentation at the 2018 International Society of Gastrointestinal Oncology.

James L. Wade III, MD, FACP, FASCO, discusses the importance of clinical trials in the community.

I think one of the most important advancements in biomedical technology that has improved our understanding of the complexities of cancer is the ability to sequence the cancer genome for any individual patient, in a rapid and cost-effective manner, to help us make treatment decisions in the clinic.

Groundbreaking developments in cancer therapies can change lives, extending survival and sending patients who previously thought their chances were slim into remission. But these therapies come at a cost, and many patients reel at the prospect of heavy financial burdens. To help patients and programs meet the challenges of affording cancer treatments, community cancer centers are expanding the role of financial advocates in their organizations.

Thomas A. Gallo, MS, MDA, president of the Association of Community Cancer Centers, discusses his mission as president to “reflect, renew, and reignite” in order to create a more resilient oncology team for the community.

Ann-Lii Cheng, MD, discusses where the of hepatocellular carcinoma is headed.

Larotrectinib induced an objective response rate of 80% in patients with advanced solid tumors who harbored&nbsp;<em>NTRK&nbsp;</em>gene fusions, according to results pooled from 3 small trials of the TRK inhibitor. Results were presented during the 2018 ESMO Congress.

Rising prescription drug prices continue to add to the burden of paying for quality healthcare. In an effort to confront such costs, the Centers for Medicare &amp; Medicaid Services has rescinded a prohibition on step therapy for Medicare Advantage plans. But some contend such a policy will reduce patient access to optimal medication.

Investigators have long known that the combination of antiangiogenic agents and immunotherapy could enhance antitumor response and improve outcomes for patients with certain cancers. But recently, this old idea has become the focus of new research in diseases such as hepatocellular carcinoma, urothelial carcinoma, and endothelial cancer.

Until recently, few systemic therapies had been approved for the treatment of patients with liver cancer, as few agents could demonstrate significant benefit over placebo. Sorafenib was the first systemic therapy that extended median overall survival over placebo by nearly 3 months,¹ and, in December 2007, it became the first systemic therapy approved by the FDA for patients with unresectable hepatocellular carcinoma.

An independent assessment conducted as part of the pivotal, international phase III REFLECT trial confirmed positive responses demonstrated by&nbsp;lenvatinib (Lenvima)&nbsp;as a first-line therapy for patients with HCC.

Ghassan K. Abou-Alfa, MD, lead investigator of the PHOCUS study,&nbsp;discusses the potential of the oncolytic virus Pexa-Vec and in patients with hepatocellular carcinoma.

Riccardo Lencioni, MD, discusses how to successfully integrate Liver Imaging Reporting and Data Systems their clinical practice.<br /> &nbsp;

Bruno Sangro, MD,&nbsp;discusses the current landscape for systemic therapies, new directions with immunotherapy, and the need for greater research into combination therapies for HCC.

Masatoshi Kudo, MD, PhD, discusses the potential for systemic therapy in the adjuvant setting of hepatocellular carcinoma. While current trials are investigating this therapy in advanced stage HCC, Kudo believes it could benefit patients following a surgery resecting an aberration.

Patients with advanced hepatocellular carcinoma who were treated with second-line regorafenib (Stivarga)&nbsp;experienced a prolonged overall survival benefit, according to a 2-year updated analysis of key findings from the pivotal RESORCE trial.

Andrew Zhu, MD, PhD, director of Liver Cancer Research and Medicine at Massachusetts General Hospital, shares his advice on making decisions for frontline treatment of patients with hepatocellular carcinoma.

Novel immunotherapy combinations are currently under investigation for the treatment of patients with&nbsp;hepatocellular carcinoma, with several promising phase III trials incorporating checkpoint inhibitors now underway. Finding successful ways to combine these therapies is among the most significant trends emerging&nbsp;as part of the next wave of discovery in the field, according to experts.

Second-line therapy with cabozantinib demonstrated efficacy in treating patients with&nbsp;hepatocellular carcinoma who also had a history of hepatitis B virus infection, according to findings from a subgroup analysis of the phase III CELESTIAL trial.&nbsp;

Josep M. Llovet, MD, PhD, founder and director of the Liver Cancer Program and professor of medicine at the Icahn School of Medicine, Mount Sinai Hospital, discusses the current treatment landscape for liver cancer and the advances seen over the last decade at the 2018 International Liver Cancer Association Annual Conference.