Hepatocellular Carcinoma | James J Harding, MD

published 5 months ago by Dr Neil Love

Hepatocellular Carcinoma Update, Issue 1, 2020 — Part 1: Our interview with Dr Harding highlights the following topics as well as cases from his practice: Clinical experience with immune checkpoint inhibitors for patients with hepatocellular carcinoma (HCC) (00:00) Immune-related adverse events associated with immune checkpoint inhibitors (01:43) Activity of nivolumab or pembrolizumab as monotherapy for HCC (04:29) Biologic rationale for combining immune checkpoint inhibitors and anti-angiogenic agents; results of the IMbrave150 study evaluating atezolizumab/bevacizumab as first-line therapy for unresectable HCC (07:45) Side effects of the atezolizumab/bevacizumab combination in IMbrave150 (10:06) Risk of bleeding, cardiovascular disease, hypertension and proteinuria with the use of bevacizumab (13:05) Perspective on the use of atezolizumab/bevacizumab for patients with liver dysfunction (15:30) Objective response rate with atezolizumab/bevacizumab versus sorafenib in the IMbrave150 study (17:26) Potential role of combination immunotherapy approaches versus locoregional modalities in the management of HCC (20:11) Novel strategies under investigation for the treatment of HCC (22:58) Case: A man in his early 50s with a history of hepatitis B receives atezolizumab/bevacizumab as first-line therapy for metastatic HCC (25:36) Role of biopsy for patients with HCC; incidence of metastatic disease at first diagnosis (27:23) Activity of atezolizumab/bevacizumab as first-line therapy (31:39) Tolerability of the atezolizumab/bevacizumab combination (33:49) Case: A man in his early 70s with metastatic HCC and nonalcoholic steatohepatitis-associated cirrhosis receives lenvatinib (36:23) Use of immune checkpoint inhibitors for patients with preexisting autoimmune disease (39:17) Efficacy and safety of lenvatinib in combination with pembrolizumab for patients with unresectable HCC (42:17) Emerging data with nivolumab/ipilimumab and tremelimumab/durvalumab for advanced HCC (45:01) Risks and benefits with anti-PD-1/PD-L1 and anti-CTLA-4 combinations versus immune checkpoint inhibitor and anti-angiogenic combinations (47:54) Therapeutic options for patients with HCC in the second-line setting (50:20) Case: A man in his early 70s with advanced hepatitis C-associated HCC receives cabozantinib after experiencing disease progression on sorafenib (53:30) Perspective on the role of immune checkpoint inhibitors alone or in combination with anti-angiogenic therapy after disease progression on sorafenib (55:07) Clinical experience with and management of tyrosine kinase inhibitor-associated toxicities (58:11) Case: A woman in her late 70s with metastatic HCC develops myasthenia gravis after treatment with nivolumab (1:02:08) Case: A woman in her late 50s with hepatitis B-associated metastatic HCC experiences a delayed response to nivolumab after enrolling in hospice care (1:06:06) Delayed responses, pseudoprogression and hyperprogression associated with immune checkpoint inhibitors (1:10:12) CME information and select publications

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