Dr. Singal on Downstaging Strategies in HCC

Amit Singal, MD, medical director of the Liver Tumor Program and clinical chief of hepatology at the University of Texas Southwestern Medical Center, discusses downstaging strategies for patients with hepatocellular carcinoma (HCC).

When patients present within the traditional Milan Criteria for Liver Transplant in the United States, disease management is straightforward, according to Singal. Patients who fall within these criteria have excellent long-term survival, Singal says. Along with recognizing the patients who were achieving long-term survival, the HCC community has also begun to acknowledge that those with larger intrahepatic tumor burden could be downstaged, Singal notes.

This can be achieved through locoregional therapies, which can help patients to fall within criteria after achieving a response to treatment. Some of these approaches include chemotherapy embolization, radiotherapy embolization, or stereotactic body radiation therapy, Singal notes. Patients who have been downstaged after responding to treatment are able to achieve excellent long-term survival that is on par with those who started and stayed within criteria, Singal concludes.