Indonesian consensus on systemic therapies for hepatocellular carcinoma

Area of Science:

• Hepatology and Oncology
• Translational Cancer Research
• Clinical Therapeutics

Background:

• Hepatocellular carcinoma (HCC) incidence is rising globally, with late diagnosis limiting curative options.
• Chronic liver disease complicates HCC management, necessitating preserved liver function for treatment.
• Sorafenib, approved in 2008, was the first systemic therapy to improve survival in advanced HCC.

Purpose of the Study:

• To provide clinicians, healthcare workers, and policymakers with updated information on systemic therapies for HCC.
• To guide clinical decision-making by summarizing evidence, safety profiles, and patient considerations for emerging HCC treatments.
• To address the unmet need for effective therapeutic options in advanced HCC.

Main Methods:

• Review of clinical evidence from phase III trials for recently approved systemic agents.
• Analysis of safety profiles and efficacy data for novel HCC treatments.
• Consensus-based recommendations for integrating new therapies into clinical practice.

Main Results:

• Several new systemic agents, including lenvatinib, regorafenib, cabozantinib, ramucirumab, and atezolizumab plus bevacizumab, have demonstrated efficacy in advanced HCC.
• These agents represent significant advances over sorafenib, offering improved outcomes for patients.
• The availability of multiple treatment options necessitates careful consideration of drug-specific data and patient factors.

Conclusions:

• The landscape of advanced HCC systemic therapy has evolved rapidly in the last five years.
• Informed clinical decision-making requires a thorough understanding of the evidence, safety, and patient characteristics for each available agent.
• This consensus aims to facilitate optimal patient care by consolidating current knowledge on HCC systemic therapies.