Ghassan K. Abou-Alfa, MD, a medical oncologist at Memorial Sloan Kettering Cancer Center, discusses the plethora of new treatment options in hepatocellular carcinoma.
Ghassan K. Abou-Alfa, MD, a medical oncologist at Memorial Sloan Kettering Cancer Center, discusses the plethora of new treatment options in advanced hepatocellular carcinoma (HCC).
2018 was a breakthrough year for the previously stagnant field of HCC. Since 2007, there had only been 1 FDA-approved drug, sorafenib (Nexavar), which was followed by negative trial after negative trial. This past year, however, several new drugs have received FDA approval. Most recently, the TKI lenvatinib (Lenvima) was granted approval for use in the frontline setting, after having demonstrated noninferiority to sorafenib for overall survival in patients with unresectable HCC.
In the second-line setting, regorafenib (Stivarga) received FDA approval for patients who progress on sorafenib. The checkpoint inhibitor nivolumab (Opdivo) has a conditional FDA approval for the second-line setting as well, Abou-Alfa notes. Researchers will know more about the role of immunotherapy in this space when results from the CheckMate-459 study are read out in the near future; this trial is evaluating nivolumab head-to-head with sorafenib in patients with advanced HCC.
Cabozantinib (Cabometyx) and ramucirumab (Cyramza) also have indications for the second-line of treatment, he adds.