Challenges When Treating Patients With Hepatocellular Carcinoma

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.