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An expert discusses how in the first-line (1L) treatment of advanced unresectable hepatocellular carcinoma (uHCC) with tyrosine kinase inhibitors (TKIs) such as lenvatinib or sorafenib, proactive adverse event (AE) management is crucial. This includes baseline assessment; regular monitoring of adverse effects such as hypertension, hand-foot syndrome, and fatigue; and implementing preventive strategies. Treatment should be individualized with dose modifications as needed to balance therapeutic efficacy with quality of life, particularly given the advanced disease state.

1 expert in this video

The panelist discusses, for intermediate-stage unresectable hepatocellular carcinoma (uHCC), key clinical pearls include prioritizing transarterial chemoembolization (TACE) as a first-line therapy, with systemic options for TACE-ineligible patients or progression; consider lenvatinib or atezolizumab plus bevacizumab based on liver function and risk factors. Evaluate treatment success via a radiologic response (mRECIST criteria), AFP levels, and toxicity profiles; modify treatment upon radiologic progression, prohibitive toxicity, or declining performance status.

1 expert in this video

An expert discusses how recent analyses from the REFLECT trial in unresectable hepatocellular carcinoma (uHCC) demonstrate that both achieving objective response and greater depth of response correlate with improved survival outcomes. The depth of response serves as a potentially valuable early biomarker for prognosis and treatment decisions, with deeper responses associated with better overall survival among responders.

1 expert in this video

An expert discusses how treatment selection for first-line (1L) tyrosine kinase inhibitor (TKI) therapy in advanced hepatocellular carcinoma (HCC) requires careful evaluation of multiple factors, including liver function (Child-Pugh status), ECOG performance status, tumor burden, and presence of macrovascular invasion or extrahepatic spread. In reviewing individual cases, clinicians assess liver enzyme levels, α-fetoprotein values, radiographic findings, and comorbidities.

2 experts in this video

Panelists discuss how combining systemic therapy with locoregional treatments like transarterial chemoembolization (TACE) aims to enhance therapeutic efficacy by addressing its limitations, such as incomplete tumor necrosis and hypoxia-induced progression. Tyrosine kinase inhibitors (TKIs) like lenvatinib and immune checkpoint inhibitors (ICIs) counteract TACE-induced resistance by inhibiting angiogenesis and boosting immune response, improving overall tumor control.

2 experts in this video

Panelists discuss how systemic therapy plays a crucial role in embolization-eligible hepatocellular carcinoma (HCC), particularly for patients with progressive or extensive disease. In locally advanced cases, systemic therapies, including immunotherapy combinations and tyrosine kinase inhibitors (TKIs), are first-line options. Patients typically transition from transarterial chemoembolization (TACE) to systemic therapy upon progression, high tumor burden, or liver function decline.