Frontline Systemic Therapy in HCC Patients

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EP: 1.Frontline Systemic Therapy in HCC Patients

EP: 2.Atezolizumab and Bevacizumab in the Phase 3 IMbrave150 Trial

EP: 3.Approval of Frontline Atezolizumab + Bevacizumab Treatment

EP: 4.Unmet Needs of HCC Management

EP: 5.Emerging Combination Therapies for HCC

EP: 6.Advice on Future Treatment of HCC

Ruth He, MD:The treatment goal of frontline systemic therapy is to prolong patients’ overall survival and preserve patients’ quality of life in addition to liver function. When I start the patient on systemic therapy, patient-related factors that I consider include whether this patient will be compliant with oral treatment. If not, I would consider intravenous combination. Does the patient already have significant fatigue? If so, then I would avoid giving a TKI [tyrosine kinase inhibitor]. I also will look at the disease-related factors.

I will assess the risk of bleeding in this patient. Is this patient symptomatic from the cancer that required a big response—and significant tumor shrinkage from the treatment—or not? Is so, then I would consider a treatment that has a higher response rate that hopefully will shrink the tumor significantly to decrease the symptoms.

Under NCCN [National Comprehensive Cancer Network] Guidelines, 3 systemic therapy options are category 1 recommendations supported by randomized phase 3 trials: sorafenib by the SHARP trial, lenvatinib by the REFLECT trial, and the combination of bevacizumab and atezolizumab supported by the IMbrave150 clinical trials.

Transcript edited for clarity.