Meet the Experts: Immunotherapy and liver cancer - Hope and gaps in the management of HCC patients

 Liver tumours

Channel 2

Meet the Experts
28 August 2020 19:00 - 19:30

Points for discussion: 

Promising results of phase 1/2 trials of monotherapy, nivo and pembro approved by the FDA

Negative phase 3 trials but confirmed clinical benefit, safety profile, QOL

Need of predictive biomarkers to select patients to be treated

Potential of combinations to expand the number of patients who may benefit

Rationale for the different combinations: IO+anti-VEGF, IO+TKI, IO+IO

Positive phase 1/2 trials in first-line (lenva-pembro) and second-line (ipi-nivo and durva-treme)

Positive phase 3 trial of atezo-bev, IMbrave150

How would you decide which treatment you would propose to a patient in first-line? Which are the factors you may consider? Outcome, safety, sequences, comorbidities, age…. How would you decide which treatment you would propose to a patient in second-line? Which are the factors you may consider? Same as above, previous treatment, potential biologic rationale for sequences… Also, how about the labels? Is there a correlation between the different healthcare systems and the proposed treatment? Europe vs US? Without thinking of the labels which is an ideal algorithm for clinical practice? And according to the labels? What is the ideal second-line after atezo-bev? And the potential third-line? With the new systemic treatment options, do you think patients will be able to be treated with locoregional therapies/surgery after systemic therapies if they respond and the disease is liver-limited?

Do you think atezo-bev is the new first-line standard for all the patients? Which are patients you wouldn’t consider for this combination? How about the upper endoscopy? Should it be mandatory in clinical practice? (the answer is obviously YES but it is worth of underlining it) Which patients can be candidate for IO monotherapy where this option is available? Without thinking of the labels which is the ideal place for IO monotherapy in clinical practice? And according to the labels? Any thoughts about anti-PD1+anti-CTLA4 after atezo-bev?