Dr. Abou-Alfa on Analyzing Disease Factors to Inform Clinical Decisions in HCC

Ghassan K. Abou-Alfa, MD, a medical oncologist, Memorial Sloan Kettering Cancer Center, discusses the analysis of disease and patient factors to inform clinical decisions in hepatocellular carcinoma (HCC).

Although examining an individual patient’s disease factors can aid in treatment decisions within HCC, current guidance is lacking, Abou-Alfa says. For example, with the combination of atezolizumab (Tecentriq) and bevacizumab (Avastin), there is serious concern about bleeding due to varices that can occur in certain patients, Abou-Alfa explains. As such, if this regimen is selected for use, it is important to perform an endoscopy in the patient, according to Abou-Alfa, who adds that the regimen should be stopped if there is any safety concern.

Due to the eligibility criteria of certain studies, questions remain regarding patients with major blood vessel involvement with their tumors, as this can affect the functionality of the liver and the benefit derived with a therapy, Abou-Alfa says. Patients with heavy vessel involvement typically would be classified as Child-Pugh class B, which would make them ineligible for most clinical trials, so it is important to gain an understanding of how certain treatments can affect this group of patients, Abou-Alfa concludes.