Richard Finn, MD
Although new therapies are being rapidly introduced in the hepatocellular carcinoma (HCC) field after years of clinical trial disappointments, clinicians face many challenges when treating patients with this malignancy, including delays in diagnosis and comorbidities.
In another development, cabozantinib (Cabometyx), a multikinase inhibitor, improved median overall survival (OS) versus placebo in patients with advanced HCC who have previously received sorafenib in the phase III CELESTIAL trial, meeting the primary endpoint. Based on these results, Exelixis, the company developing the drug, plans to submit an sNDA to the FDA in the first quarter of 2018.
Screening/Surveillance for HCC
Current guidelines do not advise routine screening for HCC in the general population. However, international and US guidelines for HCC do recommend routine screening in individuals at higher risk of developing HCC.1,2
“These are probably patients who have known cirrhosis or known hepatitis,” Finn said. Carriers of HBV have an increased risk of HCC even in the absence of cirrhosis, as do patients with HCV who have a family history of HCC or bridging fibrosis.1
Arndt Vogel, MD, PhD, said it may also be necessary to screen people with NASH, which can lead to HCC before cirrhosis occurs.2
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