Arndt Vogel, MD, is a faculty member at the University of Toronto Institute of Medical Science, a scientist at the Toronto General Hospital Research Institute, and a medical oncologist at the UHN–Princess Margaret Cancer Centre

Arndt Vogel, MD, managing senior consultant, professor, Department of Gastroenterology, Hepatology and Endocrinology, head, GI-Cancer Center, Hannover Medical School, Hannover, Germany, discusses the utility of frontline lenvatinib (Lenvima) or sorafenib (Nexavar) in hepatocellular carcinoma (HCC).

Although the combination of atezolizumab (Tecentriq) and bevacizumab (Avastin) remains the standard frontline therapy for patients with HCC, immunotherapy-based treatment is not indicated for a small proportion of patients, Vogel says. In this population, single-agent TKIs, such as lenvatinib or sorafenib, are preferred.

Treatment selection between lenvatinib and sorafenib is dependent on the patient’s individual clinical and tumor characteristics, Vogel explains. Although robust biomarkers are not available in HCC, identification of 

 amplifications, which are present in approximately 5% of patients, could inform clinical decisions. Additionally, the safety profiles of the agents, although similar, should be considered, Vogel adds. 


Notably, the higher response rate observed with frontline lenvatinib vs sorafenib in patients with unresectable HCC is a driving component of why lenvatinib is being used more frequently in clinical practice. However, more data for patients with more advanced HCC, such as those with Child-Pugh B disease, are available with sorafenib, which should be considered when selecting between the agents, Vogel concludes.

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Arndt Vogel, MD, discusses the utility of frontline lenvatinib or sorafenib in hepatocellular carcinoma.



Dr. Vogel on the Utility of Frontline Lenvatinib or Sorafenib in HCC 

Arndt Vogel, MD, PhD, professor of gastrointestinal oncology, Hannover Medical School, discusses the results of the open-label, single-arm phase II FIGHT-202 trial in cholangiocarcinoma.

Data from the phase II FIGHT-202 trial were presented at the 2019 ESMO Congress and demonstrated durable objective responses to treatment with pemigatinib in more than one-third of patients with previously treated locally advanced or metastatic cholangiocarcinoma with an 

rearrangement or fusion. Currently, there is no well established second-line therapy, says Vogel. 

The objective response rate (ORR) among patients with 

 fusions/rearrangements was 35.5%, and the median duration of response was 7.5 months. Notably, complete responses were seen in addition to partial responses, says Vogel. Notably, the higher ORR was associated with a longer median progression-free survival in patients with 

Overall survival (OS) data were immature at the time of analysis, but with a median duration of follow-up of 15.4 months and a median duration of treatment of 7.2 months, the median OS was 21.1 months in the cohort with 

Arndt Vogel, MD

Articles

Dr. Vogel on the Utility of Frontline Lenvatinib or Sorafenib in HCC

Dr. Vogel on the FIGHT-202 Trial in Cholangiocarcinoma