Mitesh J. Borad, MD
Although hepatocellular carcinoma is less frequent in the United States with less than 40,000 cases per year, the global incidence per year is estimated to be 782,000 cases, said Mitesh J. Borad, MD.
Borad says that patients can be broadly categorized into 3 stages: early-, intermediate-, and advanced-stage disease. In early-stage disease, surgery or transplant is a viable option, and in intermediate- and advanced-stage disease, locoregional therapy or systemic therapy should be considered.
Liver-directed therapies include embolization, radiofrequency ablation, cryoablation, radioembolization, alcohol ablation, and external beam radiation.
Borad said that the take-home message from these 2 studies is that Y-90 remains a reasonable modality to treat HCC, despite the negative studies. Future studies should focus on liver-limited cases and earlier-stage disease to potentially optimize the use of Y-90.
In the first-line setting, patients with advanced HCC should be treated systemically with either sorafenib or lenvatinib (Lenvima), Borad says.
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