An Abundance of Therapies for Early- and Late-Line HCC

Pierre Gholam, MD, discusses standard of care options for hepatocellular carcinoma, including newly-available therapies.

Pierre Gholam, MD, professor at Case Western Reserve University School of Medicine in Cleveland, Ohio, discusses standard of care options for hepatocellular carcinoma (HCC), as well as newly available therapies.

Ghloam explains that the treatment landscape has grown significantly in a 5-year span. In the first-line setting, options are predominantly tyrosine kinase inhibitors, and in the second-line setting, there are both targeted therapy and immunotherapy options. If patients live to received third-line treatment for HCC, cabozantinib (Cabometyx) has specifically shown efficacy in the heavily-pretreated population, according to Gholam.


0:07 | Standard of care therapy for unresectable HCC has expanded considerably over the past five years. In first line, we have standard of care options, which include the combination of a atezolizumab [Tecentriq] and bevacizumab [Avastin] and others. We also have FDA approved the tyrosine kinase inhibitors, which include sorafenib [Nexavar], and lenvatinib [Lenvima].

These agents have demonstrated efficacy and safety in large clinical trials and can certainly be used to treat patients depending on their specific clinical characteristics.

0:49 | In the second line, there are additional options which include regorafenib [Stivarga], cabozantinib, the combination of nivolumab [Opdivo] and ipilimumab [Yervoy] and ramucirumab [Cyramza] in the setting of patients who have an AFP greater than 400. These are certainly available options for many patients, and some patients managed to get the third line, and some of these options including prominently cabozantinib have been used.