Dr. Pillai on Sequential Treatment in HCC

Anjana Pillai, MD, an associate professor of medicine, medical director of the Liver Tumor Program, co-director of the Living Donor Liver Transplant Program, and director of Transplant Hepatology Fellowship Program at the University of Chicago, discusses sequential treatment in hepatocellular carcinoma (HCC).

The landscape is moving toward sequential treatment, as more first-line options are approved by the FDA, according to Pillai. Another focus will be determining which first-line therapies should be selected for each patient, especially as ongoing clinical trials conclude and report their data, Pillai says. If positive, several combination therapies may be utilized in the first-line setting, which will prompt the question of which approach should be selected for subsequent treatment, Pillai explains.

Treatment strategies for patients with HCC may be reminiscent of what had been seen in hepatitis C, where the space shifted from a handful of moderately effective drugs to a plethora of efficacious agents to choose from, Pillai explains. As such, it may not matter which drugs are selected for treatment, as they are all impactful, according to Pillai.

Once the many ongoing combination therapy trials report their findings, it will be easier to understand which patient populations will most benefit from these approaches. For patients who progress, emerging data will help to determine which agent should be used subsequently, Pillai concludes.