Richard S. Finn, MD, assistant professor of medicine, Department of Medicine, Division of Hematology/Oncology, Geffen School of Medicine, University of California, Los Angeles, recaps recent second-line advancements in hepatocellular carcinoma (HCC).
There have been many advancements in the management of patients with advanced HCC in the last year and a half, Finn says. This is in stark contrast to the previous decade, where the only drug that provided an improvement in survival in this setting was sorafenib (Nexavar). There were numerous negative studies during that time period.
Results from the RESOURCE study led to the FDA approval of regorafenib (Stivarga) as a second-line treatment for patients with HCC who have previously received sorafenib. The median overall survival (OS) in that study was 10.6 months with regorafenib plus best supportive care. This was compared with a 7.8-month median OS for placebo plus best supportive care, representing a 38% reduction in the risk of death.
Shortly after the results of RESOURCE were presented, the REFLECT study showed that first-line lenvatinib (Lenvima) was non-inferior to sorafenib. Lenvatinib is currently awaiting approval by the FDA.
Additionally, nivolumab (Opdivo) was granted an accelerated approval by the FDA for the treatment of patients with HCC following prior sorafenib in September 2017. Confirmatory data with nivolumab versus sorafenib is forthcoming.