Dr. Fonkoua on Determining First-Line Treatment Strategies in HCC

Lionel Kankeu Fonkoua, MD, medical oncologist, clinical fellow in hematology and oncology, Mayo Clinic, discusses key considerations when selecting a treatment regimen for patients with hepatocellular carcinoma (HCC).

Both the phase 3 IMbrave150 (NCT03434379) and HIMILAYA trials (NCT03298451) have introduced reliable and effective first-line treatment options in the disease space, Fonkoua begins.

Data from IMbrave150 showed that atezolizumab (Tecentriq) plus bevacizumab (Avastin) improved overall survival (OS) compared with sorafenib (Nexavar), Fonkoua explains. The combination performed better despite the inclusion of several high-risk patient groups, including those with portal vein thrombosis, Fonkoua notes.

In contrast, patients with portal vein thrombosis were excluded from the HIMILAYA trial, Fonkoua continues. A single dose of tremelimumab followed by a monthly dose of durvalumab (Imfinzi) improved OS in patients with unresectable HCC, Fonkoua adds. Based on these results, atezolizumab plus bevacizumab remains a preferred first-line option for patients without contraindications, Fonkoua concludes.