David J. Pinato, MD, PhD, discusses past and current trials that are significant for the hepatocellular carcinoma patient population.
David J. Pinato, MD, PhD, clinical senior lecturer in medical oncology, clinician scientist, and consultant medical oncologist in the Department of Surgery and Cancer at Imperial College London, discusses past and current trials that are significant for the hepatocellular carcinoma (HCC) patient population.
Atezolizumab (Tecentriq) and bevacizumab (Avastin) demonstrated superiority over sorafenib (Nexavar) for overall survival, progression-free survival, overall response rate, and patient-reported outcomes in the IMbrave150 study (NCT03434379). Pinato thinks there is plenty of evidence to show that this combination will make transformative changes to the advanced HCC setting.
Trials that are expected to report data soon for immunotherapy doublets, such as CTLA4 plus PD-1 combinations. These trials are in the frontline setting for patients with HCC. Pinato says that the frontline space will become crowded over the next few months and years. He feels that tyrosine kinase inhibitors (TKIs) will always play a role in the treatment for these patients, but the position of these therapies will shift based on the duration of response, likelihood of response, and extent of clinical benefit in patients. There is interest in this setting on how the introduction of combination immunotherapy might move TKI treatment to a later line of therapy, which has happened in other cancer settings before.