Optimizing Care for Patients With Hepatocellular Carcinoma


Richard S. Finn, MD: Hello, and thank you for joining this Targeted Oncology™ presentation titled, “Evolving Approaches for HCC in the Molecular Medicine Era.”

We are witnessing a change in the treatment paradigm for advanced hepatocellular carcinoma [HCC]. The emergence of immune checkpoint inhibitors in this space has opened the door to many exciting new questions on how to treat this difficult disease. Today, we are going to discuss how modern molecular approaches are helping to expand the therapeutic options for patients with liver cancer.

I’m Dr Richard Finn, from the David Geffen School of Medicine at UCLA [the University of California, Los Angeles]. Joining me today are my colleagues: Dr Catherine Frenette, from Scripps Health in La Jolla, California; and Dr Michael Morse, from Duke Cancer Institute, Durham, North Carolina.

Thank you so much for joining us today. Let’s dive right in.

The past few years, as mentioned, have been a really exciting time for those of us in liver cancer research, and also for our patients who have been in need of new, more effective treatment. Liver cancer is a complicated disease. I say that not to be self-serving, as a liver cancer researcher, but I say that because it’s really 2 diseases in 1, right? It is a malignancy and the complications of having tumor burden, and then it’s also almost always accompanied by underlying liver disease, chronic liver disease, cirrhosis. That is why a multidisciplinary approach is really of benefit.

As you see on our panel today, both Michael and I are medical oncologists, and Catherine is a hepatologist with interest in liver cancer. I want to open up the discussion with you, Catherine. Give us some thoughts on how you approach patients with liver cancer in the context of underlying liver disease, and give us insight into that multidisciplinary approach.

Catherine Frenette, MD: Thanks, Rich. I’m really honored to be on this panel with 2 great oncologists who are very esteemed. Hepatology has been involved in liver cancer for years. As you said, a lot the patients have underlying cirrhosis. So as a hepatologist, I feel like my job is to keep the liver as healthy as I can so the patient can continue to receive therapy for their cancer. Whether that’s locoregional therapy, surgical therapy, systemic therapy, or whatever therapy they’re going to get, I need to keep that liver as healthy as I can. That might involve discovering what the underlying cause is and may involve treating that. For instance, getting them on hepatitis C treatment or hepatitis B treatment. In patients with cancer, it’s been shown that treating the virus can actually improve their outcome. Or, getting their encephalopathy, or their ascites under control and keeping that under control while they’re undergoing their systemic treatment.

It really requires a multidisciplinary evaluation and care. We bring in hepatology, oncology, surgery, radiology—all of these different specialists—to provide the best care to patients.

Transcript edited for clarity.

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