Morris Sherman, MD
The past 18 months have included 3 drug approvals in the United States for the treatment of patients with hepatocellular carcinoma (HCC), with additional targeted therapies and checkpoint inhibitors in late stages of development. Moreover, the oncology community are awaiting later-phase data that will undoubtedly impact treatment decisions, explained Morris Sherman, MD, PhD.
The emergence of these therapeutic developments, and the excitement surrounding them, were discussed during the 12th Annual Conference of the International Liver Cancer Association (ILCA), held in London, United Kingdom.
In an interview with OncLive
, Sherman, professor of Medicine at University of Toronto and president of ILCA, shared his insight on the news and discussions coming out of this year's meeting, the surge of immunotherapy and targeted therapy research, optimal sequencing approaches, and the challenges that remain in treating patients with HCC.
OncLive: How would you characterize the overall state of the HCC landscape today?
: Immunotherapy looks very promising, but we still are waiting for the phase III results to confirm that, for example, nivolumab (Opdivo) is an effective treatment [in CheckMate-459]. At the moment, it certainly looks that way, but we need the final data. There are several other immunotherapies, and if nivolumab really turns out to be good, then presumably some of these other immunotherapies will also be very [effective].
We are going to find that, even if nivolumab works very well, there are still going to be a large number of patients who don’t respond—and that’s going to be one problem.
The second problem is that, with whatever treatment is going to be effective, there is going to be a big issue of access. This is because these are all going to be [very] expensive, [various parties] will struggle to find the resources to pay for this. Given that liver cancer is the second most common cause of cancer death, and the countries that have the most liver cancer are often poorer, access is going to be a major issue.
Let’s discuss the available frontline targeted therapies. Are there factors that would help you choose between lenvatinib (Lenvima) or sorafenib (Nexavar) for patients with HCC?
The factors that would lead someone to choose one drug over another are the same no matter what 2 drugs you’re comparing: how effective they are and how much toxicity they cause. There is not really a great deal of difference in either the efficacy or toxicity in those drugs, so it is going to be very much a question of individual choice.