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New systemic agents for hepatocellular carcinoma: an update 2020
1I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Current Opinion in Gastroenterology
|February 27, 2020
Summary
Advanced hepatocellular carcinoma (HCC) treatment has evolved. Atezolizumab plus bevacizumab shows improved survival, likely becoming the new standard of care for this challenging cancer.
Area of Science:
- Hepatocellular Carcinoma Research
- Oncology Drug Development
- Clinical Trial Analysis
Background:
- Hepatocellular carcinoma (HCC) incidence and mortality are rising globally.
- Despite advances in other cancers, HCC remains a significant health challenge.
- Existing systemic therapies for advanced HCC have limited efficacy.
Purpose of the Study:
- To review and summarize the current systemic treatment landscape for advanced HCC.
- To highlight recent advancements and emerging standards of care.
- To provide an overview of newly approved and investigated therapies.
Main Methods:
- Review of phase 3 clinical trials for advanced HCC systemic agents.
- Analysis of efficacy data, including overall survival and response rates.
- Comparison of newly approved treatments against established standards like sorafenib.
Main Results:
- Sorafenib was the sole systemic agent for advanced HCC for nearly a decade.
- Lenvatinib demonstrated non-inferiority to sorafenib in first-line treatment.
- Atezolizumab combined with bevacizumab showed superior overall survival compared to sorafenib in first-line therapy.
- Second-line options including regorafenib, cabozantinib, and ramucirumab have demonstrated survival benefits.
Conclusions:
- Systemic treatment options for advanced HCC have significantly expanded.
- The combination of atezolizumab and bevacizumab represents a major advancement and is poised to become the new standard of care.
- This combination is the first immune-checkpoint inhibitor-based regimen to show positive results in a phase 3 trial for advanced HCC, offering improved survival outcomes.
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