Systemic Therapy Advances Provide More Treatment Options in HCC

Al B. Benson, MD, professor of Medicine, Hematology and Oncology, Northwestern University Feinberg School of Medicine, discusses recent developments for the treatment of patient with hepatocellular carcinoma (HCC) with systemic therapy in the first and second line.

Benson says it’s important to determine when a patient with HCC would do best with a systemic therapy rather than a liver-targeted therapy. Recently, there have been many advances in this setting. Patients used to only have single-agent sorafenib (Nexavar) as an option, but now there are multiple kinds of approaches in the first and second line. This includes lenvatinib (Lenvima) in the first line and regorafenib (Stivargo), nivolumab (Opdivo), pembrolizumab (Keytruda), and cabozantinib (Cabometyx) as second-line therapies.

Additionally, immunotherapy has become a topic of interest for these patients according to Benson. The combination of atezolizumab (Tecentriq) plus bevacizumab (Avastin) is now FDA-approved as a treatment for patients with unresectable or metastatic HCC who have not received systemic therapy before. This was based on the IMbrave150 trial (NCT03434379).