In the second episode of a 4-part podcast series on HCC, the Oncology Brothers, Drs Rahul and Rohit Gosain, host a podcast discussion between Dr Lorenza Rimassa and Prof. Arndt Vogel on 2nd line treatment selection in advanced HCC and when to switch.
The discussion covers a range of topics, including 2nd line options for advanced HCC after progression on 1st line TKIs and IO-based therapies, as well as:
- How to approach sequencing in clinical practice
- The available data supporting sequencing strategies
- When to switch to 2nd line therapy and what to consider when doing so
This is the second video podcast episode in a 4-part series. Access the rest of the series here:
Part 1 - The use of IO in unresectable HCC
Part 3 - Intermediate HCC: treatment options and strategies (coming soon)
Part 4 - The evolving role of IO in intermediate HCC (coming soon)
Clinical takeaways
- Prospective Phase 3 data on 2nd line options in advanced HCC, particularly after immunotherapy, is limited, highlighting the need for further evidence to guide optimal treatment decisions
- When switching to 2nd line therapy, it is essential to evaluate all the available treatment options to ensure the optimal choice for each patient, considering efficacy, tolerability, liver function, and quality of life.
- Switching to 2nd line therapy should be considered in cases of clear disease progression, such as the appearance of new lesions outside the liver. Best supportive care should also be considered
- Managing side effects of 2nd line treatments (e.g. hypertension, skin toxicity, proteinuria) is critical for maintaining quality of life and providing optimal disease management
- Effective management requires a multidisciplinary team effort, including oncologists, hepatologists, interventional radiologists, and other specialists to optimise outcomes and proactively manage symptoms like hepatic decompensation.