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Therapeutic Options Available for Pancreatic Cancer, HCC Lead to New Challenges

Brandon Scalea
Published: Wednesday, Apr 03, 2019

Jimmy J. Hwang, MD

Jimmy J. Hwang, MD

An emergence of new treatment options has revitalized the outlook for patients with metastatic pancreatic cancer and advanced hepatocellular carcinoma (HCC), but the next set of unanswered questions includes the role of immunotherapy and establishing second-line standards of care, respectively, said Jimmy J. Hwang, MD.

State of the Science Summit™ on Gastrointestinal Malignancies, Hwang shed light on updates in both metastatic pancreatic cancer and advanced HCC that have created new complexities for researchers.

OncLive: How would you define the metastatic pancreatic cancer space?

Hwang: With regards to FOLFIRINOX and gemcitabine/nab-paclitaxel [in the frontline setting], how do we make the decision of who gets what? Are there ways we can do better? [Second-line therapy] was something that was inconceivable a decade ago, but it's pretty clear based on recent data that there is benefit [to using it]. Therefore, similarly to frontline therapy, what should we be doing?

How do you choose between the 2 frontline options?

You can make choices based on efficacy—at least what we perceive to be differences in efficacy. You can make decisions based on logistics and on your patient's functional status and comorbidities. The same is true in the second-line setting. Because there are several different potential options to select for, you can have those discussions with patients about what they value. What kinds of risks are they willing to take, based on the benefits each treatment may potentially bring to the table?

What therapies are being explored in clinical trials that could take these options to the next level?

As with [other solid tumors], the 2 main areas of exploration end up being immunotherapy and targeted therapy. Targeted therapy, over the course of the last few years, hasn't panned out as well as we hoped. We are always looking for new targets.
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