In the first of this 4-part podcast series on HCC, Dr Rachna Shroff and Oncology Brothers Drs Rohit and Rahul Gosain explore the use of IO (immunotherapy) in unresectable HCC (uHCC) and take a deep dive into the different treatment options first-line focusing on IO and IO based combinations. Topics include:

• Current first-line systemic treatment options for uHCC
• Efficacy and safety of IO and IO combinations including practical aspects of identifying and managing immune-mediated AEs
• How to select between the two first-line IO-based treatment options based on clinical factors and practical considerations

Key clinical takeaways:

• Two first-line IO and IO-based combinations are approved for patients with unresectable hepatocellular carcinoma (HCC), with ongoing advancements shaping the treatment landscape
• Clinical trials in newly diagnosed unresectable HCC patients have validated the effectiveness of IO plus anti-VEGF (atezolizumab + bevacizumab, IMbrave150) and dual IO (tremelimumab + durvalumab, HIMALAYA) approaches, establishing the proof of principle for these strategies
• Landmark analysis is critical in IO-based treatments due to the delayed and continued separation of survival curves. Notably, the STRIDE regimen ( single tremelimumab regular interval durvalumab) shows one in five patients achieving five-year survival in long-term follow-up
• IO and IO-based regimens for unresectable HCC are generally well-tolerated, with immune-related adverse effects manageable using steroids when necessary.
• In clinical practice, treatment choice should be individualized, taking into account factors such as potential side effects and logistical considerations, including the frequency of hospital visits

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The medical experts in this podcast are expressing their own views and not those of COR2ED, Supporters or their institution. AstraZeneca has provided a sponsorship grant towards this independent programme.

This podcast is developed by cor2ed.com

Published on November 2024

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