Dr. Singal Discusses Sequencing Therapy for HCC

Amit G. Singal, MD, associate professor, UT Southwestern Medical Center, discusses sequencing therapy for patients with hepatocellular carcinoma (HCC).

One of the most rapidly-changing fields in the gastrointestinal space is HCC. In the last 2 years, there have been multiple approvals including regorafenib (Stivarga), nivolumab (Opdivo), and most recently lenvatinib (Lenvima). Additionally, there are multiple agents awaiting FDA approval, and even more coming down the pike. Singal says that the next big question is how to sequence these therapies for patients with HCC.

Progress has been made, but clinicians need to figure out how to determine the best agent to use first, and then when to switch to another agent. Right now, patients are observed while on treated via imaging every few months, and if they have disease progression, then they will be switched to a different therapy, Singal says. Similarly, if the patient shows signs of intolerance, then they will be switch to a different therapy. New strategies for selection and sequencing must be developed, Singal concludes.