Dr Hays on the Evolution of the Treatment Landscape in HCC

John L. Hays, MD, PhD, assistant professor, the Department of Internal Medicine, the Ohio State University, member, the Translational Therapeutics Program, the Ohio State University Comprehensive Cancer Center - James Cancer Hospital, discusses the evolution of treating patients with hepatocellular carcinoma (HCC).

The emergence of new therapies and positive clinical trials have expanded the treatment landscape for patients with HCC over the past decade, Hays begins. Looking back at the treatment landscape 10 years ago, there were a minimal number of drugs that were active in patients, Hays notes adding that sorafenib (Nexavar) showed some clinical benefit. However, that clinical benefit was minimal in most patients, and treatment with sorafenib was limited to patients that displayed signs of good liver function, Hays notes.

In recent years, new approvals featuring target therapy and immunotherapy combinations have provided new treatment options for patients with HCC, Hays continues. For example, the FDA approved the combination of atezolizumab (Tecentriq) and bevacizumab (Avastin) for the treatment of patients with unresectable or metastatic HCC who have not received prior systemic therapy in May 2020 and the combination of durvalumab (Imfinzi) with tremelimumab (Imjudo) for the treatment of adult patients with unresectable HCC in October 2022.

With different targeted therapy and immunotherapy combinations approved, this has created an expanded treatment landscape with different choices to consider for each individual patient, Hays expands. Moreover, these combinations and new treatment options are helping patients live longer, and they have opened up treatment to patients who may have not been eligible for sorafenib, Hays says, noting that this was once a persistent question within HCC. Treatment options were available for patients in good health, but many patients with HCC are rarely in perfect health, he adds. These combinations could represent options for patients who do not have perfect liver function, and they have highlighted a major shift in the treatment landscape for patients with HCC, Hays concludes.