Tanios Bekaii-Saab, MD
The treatment landscape of hepatocellular carcinoma (HCC) continues to expand, with some of the biggest approvals yet occurring in the past year, including the multikinase inhibitor regorafenib (Stivarga) and the PD-1 antibody nivolumab (Opdivo). “Before 2009, I would struggle to find a reasonable option,” said Tanios Bekaii-Saab, MD. “We used so many things that did not make sense, but we were so desperate because there were absolutely no therapies.”
Current options for patients with early-stage disease include surgery or transplantation. For those with intermediate-risk disease, transarterial chemoembolization (TACE) is the optimal option, with a survival rate of 40% to 60% at 2 years. For patients with high-risk HCC, treatment with sorafenib or enrollment on clinical trials is the best avenue, Bekaii-Saab said.
In advanced HCC, liver embolotherapy techniques include TAE, which is the induction of ischemic necrosis at the arteriolar level using a permanent embolic.1
While this option is low-cost and there are no chemotherapeutic adverse events, there is the risk for postembolization syndrome as well as pulmonary emboli.
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