Dr. Abou-Alfa on Ramucirumab as Second-Line Therapy for Hepatocellular Carcinoma

Ghassan K. Abou-Alfa, MD, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses the role of ramucirumab (Cyramza) in the treatment of patients with hepatocellular carcinoma (HCC) in the second-line setting.

Based on data from the phase III REACH-2 trial, the FDA granted approval to ramucirumab monotherapy in May 2019 for the treatment of patients with HCC who have an alpha-fetoprotein (AFP) level of ≥400 ng/mL and have been previously treated with sorafenib (Nexavar), explains Abou-Alfa. While ramucirumab is only applicable to patients with this elevated level of AFP, elevated AFP levels are still complex to understand, according to Abou-Alfa.

Elevated AFP can occur due to a number of causes, including worsening disease, liver functionality, or the etiology of the disease, says Abou-Alfa. Elevated AFP and its causes require further investigation, he concludes.