Post Conference Perspectives: Immunotherapy Combinations for Unresectable HCC - Episode 4

Challenges With Novel Treatment Strategies


Ghassan K. Abou-Alfa, MD: Where does all this take us—all those new therapies? If anything, it’s good news. We like very much what we are seeing. Here in the United States at the moment we have literally 7 drugs already approved for HCC [hepatocellular carcinoma], back from 1 beforehand, 10 years apart. And now with ATEZO/BEV [atezolizumab/bevacizumab] coming onboard, hopefully followed by the other combinations like, for example, as we mentioned, the lenvatinib/PEMBRO [pembrolizumab], the cabozantinib plus atezolizumab, the DURVA/TREME [durvalumab/tremelimumab], there are a lot of other options that could be hopefully coming on board. A few questions are going to come up, 1 is how to choose, which is hard to tell yet. We have to wait for the rest of the data. And number 2 is how to sequence. We don’t know yet. We just have to wait for more data.

And lastly, who are those patients? In other words, are these patients the same, or are they different? We are really not sure because in the early days when NIVO [nivolumab] was first reported, you might recall at some point I spoke at ASCO [the American Society of Clinical Oncology] annual meeting, and many other of our colleagues spoke about that as well—we are not seeing a difference in regard to hep [hepatitis] B versus hepatitis C, for example, in regard to checkpoint inhibitors. But again, further dissection of that component based on the etiology and based on the ethnicity might play a role, but we don’t have that information yet. So, as you can see, despite all the great answers we have, there are a lot of questions that are still to be answered, and we have a lot more work to do.

Transcript Edited for Clarity