Dr. Mody Discusses Treatment Options for HCC

Kabir Mody, MD, medical oncologist, Mayo Clinic, discusses treatment options for patients with hepatocellular carcinoma (HCC).

For almost a decade, the only treatment approved for patients with HCC was sorafenib (Nexavar). In the last 2 years, multiple options came to the market, including lenvatinib (Lenvima), regorafenib (Stivarga), and nivolumab (Opdivo).

In November 2018, the FDA granted pembrolizumab (Keytruda) an accelerated approval for the treatment of patients with HCC who have previously received sorafenib. This approval was based on findings from the phase II KEYNOTE-224 trial, in which single-agent pembrolizumab induced an overall response rate of 17% among 104 patients with advanced HCC previously treated with sorafenib.

Additionally, the FDA accepted a supplemental new drug application for cabozantinib (Cabometyx) as a treatment for patients with previously-treated advanced HCC in May 2018. In the phase III CELESTIAL trial, cabozantinib improved overall survival by 2.2 months versus placebo. The FDA should have a decision for cabozantinib in this setting by January 14, 2019 based on the Prescription Drug User Fee Act.