Dr. Basu on Second-Line Therapy in HCC

Bristi Basu, MD, honorary consultant medical oncologist, University of Cambridge, discusses second-line therapy for hepatocellular carcinoma (HCC).

Researchers had not seen efficacy with any agents in the second-line setting until the RESOURCE trial. This was a phase III study with 2:1 randomization of regorafenib (Stivarga) versus sorafenib (Nexavar). These are 2 very similar tyrosine kinase inhibitors with slightly different mechanisms of action. This slight distinction allows regorafenib to have activity against VEGF-2 and FGF1. Data showed a survival advantage for regorafenib compared with placebo, 10.6 months versus 7.8 months, respectively. Response rates were modest, about 11%.

Basu adds that this was a patient population with a generally good prognosis. They were able to tolerate sorafenib at a dose of 400 mg/day for 20 days, but progressed on the treatment. There were similar adverse events with regorafenib as are seen in patients treated with sorafenib.