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Immunotherapy on the Cusp in HCC

Angelica Welch
Published: Friday, May 12, 2017

Tim F. Greten, MD

Tim F. Greten, MD

The promise of immunotherapy seen in other solid tumors is emerging in hepatocellular carcinoma (HCC), as well.

at the ILC, Tim F. Greten, MD, senior investigator, Thoracic and Gastrointestinal Oncology Branch, head, Gastrointestinal Malignancy Section, the National Cancer Institute, discussed the evolving role of immunotherapy in HCC.

OncLive: What is the current status of immunotherapy in HCC?

Greten: Basically, immunotherapy is a rapidly moving field in liver cancer. There are currently 3 published studies discussing the results from phase I and phase II studies that describe different immune checkpoint inhibitors. Currently, there is 1 large phase III trial testing a checkpoint inhibitor in combination with sorafenib in the first line. This whole field has really developed in the past 3 years.

What are some of the most promising immune-based therapies either in development or that you have seen in clinical trials?

The one that is the furthest developed is nivolumab, which is being evaluated in a phase III study. There are multiple other checkpoint inhibitors which basically utilize the same mechanism of action. Then there are cell-based therapies, which are much more difficult to do, but there is little—but good—data for some of them. 

CAR T-cell therapy is something that everyone is very excited about in the oncology field, but it has not been very successful in solid cancer. But, I know that it is being evaluated as a future possible therapy in HCC.

What are the biggest challenges in applying these newer therapies in HCC?

The biggest challenge is basically our lack of knowledge. We just need to learn more about these therapies. HCC is different than many other cancers because of its underlying disease and the liver cirrhosis, and from an immune perspective—we do understand why immune checkpoint inhibitors work in some indications, but there are a lot of indications where they do not work.
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