Dr. Singal on Emerging Systemic Therapies in HCC

Amit G. Singal, MD, associate professor, UT Southwestern Medical Center, discusses emerging systemic therapies in advanced hepatocellular carcinoma (HCC).

The first systemic therapy for the treatment of patients with HCC was FDA approved about a decade ago, Singal says. When it was implemented, oncologists said, “This is the first step, but we expect more therapies to come out over the last next several years.” A litany of negative trials soon followed—until recently. Singal says there has been an explosion of positive trials in the last year, both in the first- and second-line settings.

The REFLECT trial compared frontline lenvatinib (Lenvima) with sorafenib (Nexavar) and showed noninferior survival outcomes for lenvatinib. The RESORCE and CheckMate-040 trials were also positive in giving second-line therapy options for patients with advanced HCC, if they progress on lenvatinib or sorafenib. Regorafenib (Stivarga) and nivolumab (Opdivo) have also emerged as potential agents for this disease, Singal says.