Medical experts discuss the LAUNCH study, EMERALD-1, and LEAP-012 trials, providing updates on the progress and findings that influence the HCC treatment.

HCC Trials: Insights from the LAUNCH, EMERALD-1, and LEAP-012 Trials

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Medical experts discuss the LAUNCH study, EMERALD-1, and LEAP-012 trials, providing updates on the progress and findings that influence the treatment paradigm for hepatocellular carcinoma.

Richard Finn, MD, and David James Pinato, MD, MRCP, PhD, review locoregional therapies for hepatocellular carcinoma.

Locoregional Therapies for Intermediate-Stage HCC

Richard Finn, MD, and David James Pinato, MD, MRCP, PhD, review locoregional therapies for hepatocellular carcinoma, including transarterial chemoembolization (TACE) and radioembolization.

The key opinion leaders discuss staging systems they use in clinical practice and their effectiveness in creating treatment algorithms.

HCC Staging: Improving Treatment Strategies

The key opinion leaders discuss staging systems they use in clinical practice and their effectiveness in creating treatment algorithms, particularly with respect to Child-Pugh scores.

Richard Finn, MD, and David James Pinato, MD, MRCP, PhD, discuss driving forces for the development of hepatocellular carcinoma.

Examining the Role of Liver Function in HCC

Richard Finn, MD, and David James Pinato, MD, MRCP, PhD, discuss driving forces for the development of hepatocellular carcinoma, including different types of viral hepatitis and non-alcoholic steatohepatitis.

David J. Pinato, MD, PhD, NIHR Academic Clinical Lecturer in Medical Oncology, resident, Royal Brompton Hospital and Imperial College London, discusses pheochromocytomas (PCC) and paragangliomas (PGL).

PCCs and PGLs are very rare types of neuroendocrine tumors with poor prognoses, with 20% to 30% of patients either recurring after surgery, or presenting with metastatic disease for which there are no effective treatments.

When the interplay between hypoxia and the regulation of PD ligands were investigated, Pinato says that 15% to 20% of patients with PCCs and PGLs displayed an upregulation of either PD-L1 or PD-L2, suggesting that these 2 targets are somehow involved in the immune tolerogenic environment of these tumors.

David J. Pinato, MD, PhD, NIHR Academic Clinical Lecturer in Medical Oncology, resident, Royal Brompton Hospital and Imperial College London, discusses pheochromocytomas and paragangliomas.

Dr. Pinato Discusses Pheochromocytomas and Paragangliomas

David James Pinato, MD, MRCP, PhD, faculty of Medicine, Department of Surgery and Cancer, NIHR Academic Clinical Lecturer, Imperial College London, discusses a study of sorafenib (Nexavar) in pretreated patients with hepatocellular carcinoma (HCC).

This was an observational study conducted to establish whether prior treatment to sorafenib was a determinant of survival in patients with HCC.

It did not matter whether the patient was in an advanced stage of the disease or intermediate, says Pinato—if they had received treatment prior to starting sorafenib, their survival was better.

According to Pinato, this study shows that the sequencing of treatment in this patient population can have an effect on survival.

Dr. Pinato on Study of Sorafenib in Pretreated Patients With HCC

David James Pinato, MD, MRCP, PhD, Faculty of Medicine, Department of Surgery and Cancer, NIHR Academic Clinical Lecturer, Imperial College London, discusses a study of intratumor heterogeneity in the regulation of immune-tolerogenic pathways in primary and metastatic hepatocellular carcinoma (HCC).

Recent biomarker studies have shown that PD-1/PD-L1 targeted therapies are an efficacious systemic treatment for patients with HCC, says Pinato. PD-1 is already used as a biomarker in clinical trials, but trials in solid tumors suggest heterogeneity in PD-L1 expression in the primary metastatic population as well.

Based on this, a study was conducted to analyze PD-L1 and PD-L2 expression by immunohistochemistry. Pinato says the findings of this study may have implications for how patients are selected for immunotherapy, but that needs further research.

View more from the 2017 International Liver Congress

David James Pinato, MD, MRCP, PhD, Faculty of Medicine, Department of Surgery and Cancer, NIHR Academic Clinical Lecturer, Imperial College London, discusses a study of intratumor heterogeneity in the regulation of immune-tolerogenic pathways in primary and metastatic hepatocellular carcinoma.

David James Pinato, MD, MRCP, PhD

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