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Checkpoint Inhibitors, TKIs, and Novel Agents Poised to Enter Liver Cancer Treatment Paradigm

Gina Columbus @ginacolumbusonc
Published: Tuesday, Dec 19, 2017

Dr Ghassan Abou-Alfa
Ghassan Abou-Alfa, MD
Prior to 2017, the hepatocellular carcinoma (HCC) space had little movement in therapeutic advancements beyond standard sorafenib (Nexavar).

State of the Science SummitTM on Gastrointestinal Cancers, Abou-Alfa, a medical oncologist at Memorial Sloan Kettering Cancer Center, discussed what he sees coming down the pike in HCC with regard to novel agents, including CAR T-cell therapy, and the burgeoning questions with optimal sequencing of these treatments.

OncLive®: A lot has been happening in this field as of late. What would you like to highlight?

Abou-Alfa: It has been great to be here tonight for the State of the Science SummitTM, and it was a great honor to talk about primary liver cancer, especially this year. This has been an incredible year and positive time regarding our therapies for [patients with] liver cancer. As we both know, liver cancer had only one therapy, sorafenib, that was approved by the FDA almost 10 years ago. If anything, we have been trying for the past 10 years to see how we can improve on the outcome of sorafenib either by trying different things—by going into combination therapies, or even looking at second-line therapy.

But this time, we took a different perspective with cabozantinib where we allowed all patients to enroll and the trial is positive. We don’t have data yet but, as already announced in the public releases, we expect to present the data at the 2018 Gastrointestinal Cancers Symposium. That is, in brief, where things stand.

Though it is early, how do you foresee an FDA approval of cabozantinib shaking up the paradigm?

Actually, this question is very important. It is not only dependent the cabozantinib data; it is going be dependent on many other data, including nivolumab. In other words, how are we going to line up those therapies? [Do you decide by saying things] like, “I like this drug. I’m used to that drug” or “Is [this drug] more tolerated?” There is more to the story.

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