Dr. Ulahannan on Immunotherapy in Hepatocellular Carcinoma

Susanna Ulahannan, MD, assistant professor, Section of Hematology/Oncology, associate director, Oklahoma TSET Phase I Program, Stephenson Cancer Center, The University of Oklahoma, discusses immunotherapy in hepatocellular carcinoma (HCC).

In the field of HCC, physicians have sorafenib (Nexavar) in the first-line setting, and nivolumab (Opdivo) and regorafenib (Stivarga) in the second-line setting. Physicians also have the data with cabozantinib (Cabometyx) and lenvatinib (Lenvima) as well as with ramucirumab (Cyramza). All these agents are being reviewed for FDA approval.

However, HCC is very different from other cancers, explains Ulahannan. Physicians have to look at the cancer as well as liver function and liver disease. With immunotherapy, physicians can better treat these patients, as it can work even if a patient has poor liver function, explains Ulahannan.

Patients who have hepatitis B or C are also eligible for immunotherapy. At the 2018 ASCO Annual Meeting, very early data on a small number of patients were presented with a PD-L1 inhibitor in combination with bevacizumab (Avastin). These were encouraging data, with about a 60% response rate, says Ulahannan.