The LEGACY Study in 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

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

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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: Ed, I want to go back to you on the LEGACY trial, which included BCLC-C [Barcelona Clinic Liver Cancer stage C]. Who are those patients who really fit BCLC-C? Interestingly, we are going back to you for local therapy.

Edward Kim, MD: Part of the LEGACY trial is the advanced-stage population. There was also a trial, DOSISPHERE-01, which is a phase 2 RCT [randomized controlled trial] that was out of France, and particularly the portal vascular invasion patients who had a 26.6-month median overall survival benefit with radioembolization in this study. Those patients will benefit from radioembolization in the advanced stage. As everyone has mentioned, not everyone is a great candidate for either checkpoint inhibitor alone or in combination with a TKI [tyrosine kinases inhibitor]. The study that was published in Nature showed that patients in these large, randomized controlled studies who did not have viral etiologies to their HCC [hepatocellular carcinoma] didn’t respond as well to these therapies. We’ve been getting more of those patients for locoregional therapies to treat the advanced stage, but for most others, we will probably combine systemic therapies with the locoregional therapies in the hopes of getting an immunomodulatory effect in combining those therapies. There are many trials, the LEAP-012 and the EMERALD-1, that are ongoing that are trying to figure out if there is an immunomodulatory effect. That is hopefully the future, with 35% objective response. We’re trying to do better than that based on, for instance, IMbrave150.

Transcript Edited for Clarity