Dr. Llovet on Combination Therapy in HCC

Josep M. Llovet, MD, PhD, founder and director of the Liver Cancer Program, full professor of medicine, Icahn School of Medicine, Mount Sinai Hospital, discusses the potential of combination therapy in hepatocellular carcinoma (HCC).

Combination therapies have been emerging and could represent the future of HCC treatment over the next 3 to 5 years, Llovet says. Recent data have indicated that checkpoint inhibitors are effective for a proportion of patients, about 20% to 30%. These patients achieve durable responses and very good long-term outcomes with immunotherapy. Conversely, this type of therapy has not been relevant for the other 70% to 80% of patients with HCC. Combinations of tyrosine kinase inhibitors, monoclonal antibodies, and checkpoint inhibitors could have an impact, Llovet says.

Findings of a phase Ib study of atezolizumab (Tecentriq) combined with bevacizumab (Avastin) has shown objective response rates of greater than 60%, which is unheard of in advanced HCC. Lenvatinib (Lenvima) plus pembrolizumab (Keytruda) has also shown promise.