Dr. Musher on Current Therapies for HCC

Benjamin Leon Musher, MD, associate professor of medicine, hematology and oncology, Baylor College of Medicine, discusses the current treatment options for patients with hepatocellular carcinoma (HCC).

There are many options for second- and third-line therapy in HCC, making the field confusing, explains Musher. There are currently 2 drugs approved for first-line use and the combination of atezolizumab (Tecentriq) and bevacizumab (Avastin) may soon become available, depending on the reported phase III data, says Musher.

One challenge is that the trials that have reported on second- and later-line therapies examined patients who were treated with frontline sorafenib (Nexavar), meaning the sequencing will become difficult, according to Musher. Without giving the same class of agents twice, Musher recommends sequencing the best options first while considering comorbidities, performance status, liver functions, prior transplant, oral or intravenous medication, and alpha-fetoprotein levels. It is not a one-size-fits-all approach for all patients, concludes Musher.