Dr. Singal on the FDA Approval of Durvalumab With Tremelimumab in Unresectable HCC

Amit Singal, MD, medical director, Liver Tumor Program, clinical chief, Hepatology, professor, Department of Internal Medicine, Dedman Family Scholar in Clinical Care, Willis C. Maddrey, MD, Distinguished Chair in Liver Disease, University of Texas (UT) Southwestern Medical Center, discussesthe FDA approval of durvalumab (Imfinzi) with tremelimumab (Imjudo) in unresectable hepatocellular carcinoma (HCC).

In October 2022, the FDA approved durvalumab in combination with tremelimumab for the treatment of adult patients with unresectable HCC, administered via the Single Tremelimumab Regular Interval Durvalumab (STRIDE) regimen.

The approval of the STRIDE regimen is a notable advance in the field of HCC amid the growing treatment landscape for patients, Singal says. Moreover, there has been a marked improvement with this regimen in the survival of patients with advanced stage HCC extending over a year, Singal adds.

As more therapies become available, a complexity lies in deciding between the first-line therapies thatare available, Singal continues. For example, when treating patients with atezolizumab (Tecentriq) and bevacizumab (Avastin), it is important to be aware of those with contraindications to bevacizumab, Singal says. Moreover, these patients have a higher risk of gastrointestinal bleeding with bevacizumab, making it important to consider other options or regimens for this patient population, Singal emphasizes.

The STRIDE regimen can be a reasonable option to consider in these patients, Singal adds. Overall, inpatients who are at high risk of bleeding or have a history of bleeding should be considered for the STRIDE regimen, Singal concludes.