Dr. Salem on Selecting the Appropriate Treatment Approach in HCC

Riad Salem, MD, vice chair for Image Guided Therapy, Department of Radiology, chief of Vascular and Interventional Radiology in the Department of Radiology, and professor of Radiology (Vascular and Interventional Radiology), Medicine (Hematology and Oncology) and Surgery (Organ Transplantation) at the Feinberg School of Medicine, discusses considerations for selecting the appropriate treatment approach for patients with hepatocellular carcinoma.

Lesions that are visible via ultrasound, that are less than 3 cm, or are isolated from critical structures, are well suited to ablative therapy, according to Salem. However, if the lesion is more difficult to identify or is closer to adjacent structures, arterial locoregional therapy or external radiotherapy are recommended, Salem says.

If both options have failed, or the patient is not a candidate for these approaches, systemic therapies can be considered. Agents such as lenvatinib (Lenvima) are generating excitement in the downstaging setting due to the high response rates observed with its use, according to Salem. Although these agents need to be further studied and understood, these strategies are viable depending on the patient's clinical factors, Salem concludes.