Dr. Ahn on Navigating Among Available Therapeutic Options in Advanced, Unresectable HCC

Daniel H. Ahn, DO, an oncologist, internist, and assistant professor of medicine at Mayo Clinic, shares how to navigate among the therapeutic options available for patients with advanced, unresectable hepatocellular carcinoma (HCC).

Results from the phase 3 SHARP trial (NCT00105443) led to FDA approval of sorafenib (Nexavar). For years, this agent was one of the only available treatments options for this patient population, according to Ahn. Recently, more approaches have been approved by the FDA for use in the frontline and refractory settings, Ahn notes.

The question of how to best provide these treatments to patients remains, Ahn explains. As such, optimal sequencing must be considered. When choosing among the therapeutic options available factors such as the mechanism of action of each agent, and what patients received in the frontline setting should be used to inform the decision, Ahn says.

Based on results from the phase 3 IMbrave150 trial (NCT03434379), most patients with advanced, unresectable HCC are given the combination of atezolizumab (Tecentriq) and bevacizumab (Avastin), unless contraindicated, Ahn adds. Because the combination significantly improved progression-free survival and overall survival compared with sorafenib, it has become a standard regimen for this population, Ahn concludes.