Advances in Locoregional Therapy for Early Stage HCC

EP: 1.Screening for Early Stage HCC

EP: 2.Diagnostic Testing for Early Stage HCC

EP: 3.Diagnosing Early-Stage HCC via Biopsy

EP: 4.Current Role of Locoregional Therapy for Early Stage HCC

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EP: 5.Advances in Locoregional Therapy for Early Stage HCC

EP: 6.Neoadjuvant Therapy to Downstage HCC

EP: 7.Hepatic Arterial Infusion Chemotherapy for HCC

EP: 8.Adjuvant Treatment Advances in Operable HCC

EP: 9.Scoring/Classifying Patients With Advanced HCC

EP: 10.Systemic Treatment Advances for Advanced HCC

EP: 11.Frontline IO for Advanced HCC

EP: 12.Selecting First-Line Therapy for Advanced HCC

EP: 13.The LEGACY Study in HCC

EP: 14.HCC: IO in Liver Transplant Recipients

EP: 15.The COSMIC-312 Study in Advanced HCC

EP: 16.Second-Line Treatment Approaches for Advanced HCC

EP: 17.Biomarkers to Guide HCC Treatment Decisions

EP: 18.Optimizing Precision Medicine in HCC

Tanios S. Bekaii-Saab, MD, FACP: Rachna, I want to go to you on this. We’ve seen in the past quite a bit of activity with sorafenib, which is mildly active at best, and around TACE [transarterial chemoembolization] and around surgery, and overall, we’ve seen more failures than successes. As systemic therapy continues to evolve in the more advanced setting, do you see any role for systemic therapy, peri-TACE, or peri locoregional therapy, whatever that locoregional therapy could be?

Rachna Shroff, MD: There are a number of trials ongoing to investigate these questions. A multidisciplinary conversation that involves looking at locoregional therapy in conjunction with systemic therapy absolutely needs to be part of this conversation now. Referral patterns and such are very different, obviously, across the country and across the globe. Sometimes people come in via hepatology to interventional radiology, and then by the time the medical oncologists see them, they’re Child-Pugh C score, and there’s not a whole lot we can offer. That’s why it’s really important we recognize this collaborative hand-in-hand approach because now to your point, Tony, we have systemic therapies, so it’s a world post-sorafenib. That’s an important question, and the trials that are ongoing will hopefully give us prospective definitive data in this area. Right now, we’re talking, we think that makes sense, but we don’t really know yet.

To your point Ed, about radioembolization and chemoembolization, a lot of the studies right now are looking specifically at chemoembolization, while there’s a shift, I would say at least in the United States, more toward a TARE [transarterial radioembolization] approach. It’s a little frustrating that I don’t know we’re going to get all of the answers we need simultaneously. But I absolutely think there’s going to be a role for that kind of combinatorial approach.

Transcript Edited for Clarity