Joseph Kim, MD, professor of surgery and chief, Division of Surgical Oncology, University of Kentucky Markey Cancer Center, the utility of atezolizumab (Tecentriq) plus bevacizumab (Avastin) in patients with hepatocellular carcinoma (HCC).

In the past few years, several breakthroughs have been made in the gastrointestinal malignancies space, especially regarding immunotherapy. Notably, checkpoint inhibitors, like atezolizumab, target proteins on the surface of cancer cells, along with immune cells that prevent the destruction of cancer cells, Kim explains. Ultimately, these agents permit immune defenses to effectively kill cancer cells, Kim says.

In the phase 3 IMbrave150 trial, patients with unresectable HCC were randomized 2:1 to receive atezolizumab plus bevacizumab or sorafenib (Nexavar) until loss of clinical benefit or unacceptable toxicity. Notably, bevacizumab works by modulating the tumor vasculature, allowing the immune cells to invade and destroy the cancer cells. This trial demonstrated synergism between atezolizumab and bevacizumab among patients with HCC, Kim concludes.

Videos

Joseph Kim, MD, on the utility of atezolizumab plus bevacizumab in patients with hepatocellular carcinoma. 

Dr. Kim on the Utility of Atezolizumab/Bevacizumab in HCC 

Joseph Kim, MD, professor of surgery and chief, Division of Surgical Oncology, University of Kentucky Markey Cancer Center, discusses the multidisciplinary management of hepatocellular carcinoma (HCC).

When patients with HCC present to Markey Cancer Center, their case is discussed at a multidisciplinary tumor board, Kim says. This is done in order for all health care professionals involved in the patient's treatment to present their expertise and formulate a treatment strategy.

It starts with the radiologist who interprets the imaging studies, followed by the pathologist who reviews the biopsy if one has been performed. Radiation oncologists, medical oncologists, and surgeons, which may include transplant surgeons and hepatobiliary surgeons, are involved in the optimal management of this disease, making treatment multidisciplinary in nature, Kim concludes.

Joseph Kim, MD, discusses the multidisciplinary management of hepatocellular carcinoma.

Dr. Kim on the Multidisciplinary Management of HCC

Joseph Kim, MD, professor of surgery and chief, Division of Surgical Oncology, University of Kentucky Markey Cancer Center, discusses the evolution of therapy in metastatic hepatocellular carcinoma (HCC). 

Patients with metastatic HCC that has spread beyond the liver or locally advanced disease for which surgery or regional therapies are not options, are eligible to receive systemic therapy, explains Kim. 

In 2007, sorafenib (Nexavar) became the first approved, targeted option to show benefit in patients with metastatic HCC, Kim says. Now, other options, such as atezolizumab (Tecentriq) in combination with bevacizumab (Avastin), have demonstrated an overall survival benefit compared with sorafenib in this patient population, concludes Kim.

Joseph Kim, MD, discusses the evolution of therapy in metastatic hepatocellular carcinoma.  



Dr. Kim on the Evolution of Therapy in Metastatic HCC 

Joseph Kim, MD, professor of surgery and chief, Division of Surgical Oncology, University of Kentucky Markey Cancer Center, discusses curative therapeutic options in hepatocellular carcinoma (HCC). 

Curative surgical intervention is considered the best treatment option for eligible patients with HCC, says Kim, including surgical resection of the disease. However, surgical resection is often limited based on whether the patient has cirrhosis and the extent of the liver injury. Alternatively, liver transplant could offer curative potential and is able to treat the cirrhosis, Kim explains. 

Additionally, ablation of the HCC could be performed in the operating room by the surgeon or in the radiology department by an interventional radiologist, Kim concludes.

Joseph Kim, MD, discusses curative therapeutic options in hepatocellular carcinoma.  


Joseph Kim, MD

Articles

Dr. Kim on the Utility of Atezolizumab/Bevacizumab in HCC

Dr. Kim on the Multidisciplinary Management of HCC

Dr. Kim on the Evolution of Therapy in Metastatic HCC

Dr. Kim on Curative Treatment Options in HCC