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FDA approved a phase 3 trial to assess amezalpat with the current standard of care in unresectable or metastatic hepatocellular carcinoma.</p></a></a></div></div><div class="flex-wrap w-[60%] flex "><a class="flex w-[50%] flex-col sm:pl-[35px] pl-[20px] pb-[35px] " href="/view/liver-cancer-risk-assessments-new-tool-beats-standard-screening"><div class="w-full lg:h-[134px] h-[100px] relative bg-default-logo-background "><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" class="lg:object-cover object-contain " 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class="jsx-4064126826 w-full h-full flex flex-col overflow-hidden relative bg-white text-center"><div class="jsx-4064126826 relative w-full shadow-md shadow-grey-800 aspect-video"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" class="object-cover" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fdb06462140bf8debe809df7db49ea59a74776755-490x273.png%2FDr%2520Michael%2520Morse.png%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, 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/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fdb06462140bf8debe809df7db49ea59a74776755-490x273.png%2FDr%2520Michael%2520Morse.png%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fdb06462140bf8debe809df7db49ea59a74776755-490x273.png%2FDr%2520Michael%2520Morse.png%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fdb06462140bf8debe809df7db49ea59a74776755-490x273.png%2FDr%2520Michael%2520Morse.png%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fdb06462140bf8debe809df7db49ea59a74776755-490x273.png%2FDr%2520Michael%2520Morse.png%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="object-cover" loading="lazy"/></noscript></span></div><div class="jsx-4064126826 content-wrap"><span class="jsx-4064126826 py-3 text-sm text-gray-500 text-left"><i class="jsx-4064126826">April 5th 2024</i></span><div class="jsx-4064126826 w-full h-fit mb-4"><p class="jsx-4064126826 text-[18px] font-bold text-[#000000] text-left line-clamp-3 text-hidden">Dr Michael Morse Discusses Current HCC Treatment Strategies and Future Directions</p></div></div></div></a></div></div></div><div class="flex items-center space-x-4 border-0 border-b border-secondary select-none py-1"><h2 class="text-3xl text-primary">More News</h2></div><div class="flex flex-wrap w-full pb-4"><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-1"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/study-adding-anti-pd-1-to-tace-plus-lenvatinib-does-not-improve-pfs-in-unresectable-hcc"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/b10df5c7b4883c2d6e59e4aeb5c7239987ce707a-3600x2400.jpg?fit=crop&auto=format" alt="A retrospective study aimed to determine whether adding PD-1 inhibitors to TACE plus lenvatinib improved the prognosis of patients with unresectable hepatocellular carcinoma. | Image credit: Crystal light - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">July 3rd 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/study-adding-anti-pd-1-to-tace-plus-lenvatinib-does-not-improve-pfs-in-unresectable-hcc">Study: Adding Anti–PD-1 to TACE Plus Lenvatinib Does Not Improve PFS in Unresectable HCC</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/study-adding-anti-pd-1-to-tace-plus-lenvatinib-does-not-improve-pfs-in-unresectable-hcc"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The addition of PD-1 inhibitors to first-line treatment with transarterial chemoembolization (TACE) plus lenvatinib for hepatocellular carcinoma (HCC). </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/cbo-report-assesses-budgetary-effects-of-potential-policies-to-increase-hepatitis-c-treatment"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/3b2aadaa4bd3856f8b6bc28898a494f1fb4fffcd-1200x801.jpg?fit=crop&auto=format" alt="Woman holding liver representation | Image credit: LIGHTFIELD STUDIOS - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">June 21st 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/cbo-report-assesses-budgetary-effects-of-potential-policies-to-increase-hepatitis-c-treatment">CBO Report Assesses Budgetary Effects of Potential Policies to Increase Hepatitis C Treatment</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/cbo-report-assesses-budgetary-effects-of-potential-policies-to-increase-hepatitis-c-treatment"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Health care spending avoided by increased hepatitis C treatment could more than offset direct spending on increased treatment, according to a new report from the Congressional Budget Office (CBO).</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/promising-biomarker-predicts-tare-treatment-response-in-hcc"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/f6ab8b099bcd4784b7a79e513d54a1ee2751a2b0-1200x628.jpg?fit=crop&auto=format" alt="Liver cancer | Image Credit: Crystal light - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">June 18th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/promising-biomarker-predicts-tare-treatment-response-in-hcc">Promising Biomarker Predicts TARE Treatment Response in HCC</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/karen-jacobson-sive">Karen Jacobson-Sive</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/promising-biomarker-predicts-tare-treatment-response-in-hcc"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The albumin-bilirubin score is a reliable predictor of treatment response for hepatocellular carcinoma (HCC) after yttrium 90 transarterial radioembolization (TARE). </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/study-highlights-increasing-global-health-burden-of-liver-cancer"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/144b5eb40a7906769a0da9c1a955868df95b72e1-7008x3942.jpg?fit=crop&auto=format" alt="Man holding liver illustration - SewcreamStudio - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">June 12th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/study-highlights-increasing-global-health-burden-of-liver-cancer">Study Highlights Increasing Global Health Burden of Liver Cancer</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/study-highlights-increasing-global-health-burden-of-liver-cancer"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The global burden of liver cancer is rising, and public health efforts for prevention, vaccination, and treatment to address underlying etiologies are needed, according to research presented at ASCO 2024. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/dr-amit-singal-on-the-improving-outlook-for-hcc-and-how-to-choose-treatments"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/994167c0339c9d175390cbd2c7f2155695d5335a-630x335.png?fit=crop&auto=format" alt="Amit Singal, MD, UT Southwestern Medical Center" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">June 10th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/dr-amit-singal-on-the-improving-outlook-for-hcc-and-how-to-choose-treatments">Dr Amit Singal on the Improving Outlook for HCC and How to Choose Treatments</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/dr-amit-singal-on-the-improving-outlook-for-hcc-and-how-to-choose-treatments"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Amit Singal, MD, medical director of the Liver Tumor Program at UT Southwestern Medical Center, discussed the current outlook for patients with hepatocellular carcinoma (HCC) and how to choose between therapies.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/camrelizumab-plus-rivoceranib-improves-survival-vs-standard-first-line-care-for-hcc"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/d82b2b80cb7a6a4fb63ba72fdc7cc94dd3946d4b-3600x2400.jpg?fit=crop&auto=format" alt="Hepatocellular carcinoma illustration | Image credit: Crystal light - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">June 5th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/camrelizumab-plus-rivoceranib-improves-survival-vs-standard-first-line-care-for-hcc">Camrelizumab Plus Rivoceranib Improves Survival vs Standard First-Line Care for HCC</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/camrelizumab-plus-rivoceranib-improves-survival-vs-standard-first-line-care-for-hcc"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">In the final overall survival analysis of the phase 3 CARES-310 trial, frontline camrelizumab plus rivoceranib continued to show clinically meaningful survival benefits vs sorafenib for hepatocellular carcinoma (HCC). </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-7"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/screening-patients-with-hcc-risk-factors-linked-with-reduced-mortality"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/b10df5c7b4883c2d6e59e4aeb5c7239987ce707a-3600x2400.jpg?fit=crop&auto=format" alt="Illustration of hepatocellular carcinoma | Image credit: Crystal light - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">May 17th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/screening-patients-with-hcc-risk-factors-linked-with-reduced-mortality">Screening Patients With HCC Risk Factors Linked With Reduced Mortality </a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/screening-patients-with-hcc-risk-factors-linked-with-reduced-mortality"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">A recent study found that screening for hepatocellular carcinoma (HCC) is associated with reduced mortality, highlighting the need to promote HCC screening for patients with known risk factors.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/novel-blood-biomarkers-show-potential-for-early-liver-cancer-diagnosis"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/b0992f790145ffde963467c87d84a18267963f8c-1200x724.jpg?fit=crop&auto=format" alt="Molecule of DNA inside test tube illustration | Image credit: Connect world - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">May 2nd 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/novel-blood-biomarkers-show-potential-for-early-liver-cancer-diagnosis">Novel Blood Biomarkers Show Potential for Early Liver Cancer Diagnosis</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/novel-blood-biomarkers-show-potential-for-early-liver-cancer-diagnosis"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">A predictive model using plasma proteins as biomarkers predicted hepatocellular carcinoma development more accurately than a model based on traditional lifestyle risk factors in a recent study.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/real-world-data-show-racial-disparities-in-hcc-outcomes-resource-utilization"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/5ffaa2b7f4832daefa4cbc2a2879fa226475d0c1-4200x2400.jpg?fit=crop&auto=format" alt="Liver cancer | Image credit: Rasi - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">April 19th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/real-world-data-show-racial-disparities-in-hcc-outcomes-resource-utilization">Real-World Data Show Racial Disparities in HCC Outcomes, Resource Utilization </a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/real-world-data-show-racial-disparities-in-hcc-outcomes-resource-utilization"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The findings suggest there are ongoing disparities between Black and White patients with hepatocellular carcinoma (HCC) in terms of both outcomes and health care resource utilization.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/deep-learning-model-predicts-response-to-combination-therapy-prior-to-treatment-in-hcc"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/ac746dd7a033f3182a811354163e268fc1fb0448-1043x664.jpg?fit=crop&auto=format" alt="AI in medicine | Image credit: ipopba - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">April 5th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/deep-learning-model-predicts-response-to-combination-therapy-prior-to-treatment-in-hcc">Deep Learning Model Predicts Response to Combination Therapy Prior to Treatment in HCC </a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/deep-learning-model-predicts-response-to-combination-therapy-prior-to-treatment-in-hcc"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Researchers developed a web server that can help predict therapeutic responses to combination lenvatinib and immune checkpoint inhibitors in patients with unresectable hepatocellular carcinoma (HCC). </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/machine-learning-model-predicts-hepatocellular-carcinoma-risk-in-patients-with-masld"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/d82b2b80cb7a6a4fb63ba72fdc7cc94dd3946d4b-3600x2400.jpg?fit=crop&auto=format" alt="Machine Learning Model Predicts Hepatocellular Carcinoma Risk in Patients With MASLD" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">March 22nd 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/machine-learning-model-predicts-hepatocellular-carcinoma-risk-in-patients-with-masld">Machine Learning Model Predicts Hepatocellular Carcinoma Risk in Patients With MASLD</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/machine-learning-model-predicts-hepatocellular-carcinoma-risk-in-patients-with-masld"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Machine learning models have potential for early identification of patients with metabolic dysfunction-associated steatotic liver disease (MASLD) who are at risk of hepatocellular carcinoma.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/fda-approves-resmetirom-first-treatment-for-nash-with-liver-fibrosis"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/c7cf616b4745bcf4a0eedc1ff2683ef934552f7f-6000x4000.jpg?fit=crop&auto=format" alt="Blue FDA approved stamp | Imaged credit: Olivier Le Moal - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">March 14th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/fda-approves-resmetirom-first-treatment-for-nash-with-liver-fibrosis">FDA Approves Resmetirom, First Treatment for NASH With Liver Fibrosis</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/laura-joszt">Laura Joszt, MA</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/fda-approves-resmetirom-first-treatment-for-nash-with-liver-fibrosis"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The first medication for the treatment of nonalcoholic steatohepatitis (NASH) and liver fibrosis received accelerated approval. Previously, the only treatment available to patients was implementing lifestyle changes aimed at weight reduction.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-13"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/study-finds-increasing-hepatocellular-carcinoma-incidence-mortality-in-the-us"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/144b5eb40a7906769a0da9c1a955868df95b72e1-7008x3942.jpg?fit=crop&auto=format" alt="Man holding liver illustration | Image credit: SewcreamStudio - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">March 10th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/study-finds-increasing-hepatocellular-carcinoma-incidence-mortality-in-the-us">Study Finds Increasing Hepatocellular Carcinoma Incidence, Mortality in the US</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/study-finds-increasing-hepatocellular-carcinoma-incidence-mortality-in-the-us"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">An analysis of nationwide data over 2 decades identified demographic-specific trends in liver cancer incidence and mortality in the US. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/novel-assessment-accurately-predicts-nutritional-risk-in-patients-with-hcc"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/4a5b2b89e3904c2f32cdf3344bfdc640b567ef38-6000x4000.jpg?fit=crop&auto=format" alt="Nutritional Counseling - shidlovski - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">March 8th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/novel-assessment-accurately-predicts-nutritional-risk-in-patients-with-hcc">Novel Assessment Accurately Predicts Nutritional Risk in Patients With HCC</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/novel-assessment-accurately-predicts-nutritional-risk-in-patients-with-hcc"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">A novel model for gauging nutritional risk among patients with hepatocellular carcinoma (HCC) showed high accuracy and may provide a simpler, more targeted alternative to currently used nutritional risk models used for patients with cancer.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/study-finds-distinct-tumor-microenvironment-characteristics-in-hbv-related-hcc"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/b10df5c7b4883c2d6e59e4aeb5c7239987ce707a-3600x2400.jpg?fit=crop&auto=format" alt="Illustration of hepatocellular carcinoma - Crystal light - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 28th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/study-finds-distinct-tumor-microenvironment-characteristics-in-hbv-related-hcc">Study Finds Distinct Tumor Microenvironment Characteristics in HBV-Related HCC</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/study-finds-distinct-tumor-microenvironment-characteristics-in-hbv-related-hcc"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The analysis revealed that viral hepatocellular carcinoma (HCC) had a distinct microbial signature vs non-viral HCC, although only hepatitis B virus–related HCC showed a significantly diverse tumor microbiome.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/patients-with-early-vs-advanced-hcc-show-distinct-gut-microbiota-alterations"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/d82b2b80cb7a6a4fb63ba72fdc7cc94dd3946d4b-3600x2400.jpg?fit=crop&auto=format" alt="Hepatocellular carcinoma illustration | Image credit: Crystal light - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 21st 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/patients-with-early-vs-advanced-hcc-show-distinct-gut-microbiota-alterations">Patients With Early vs Advanced HCC Show Distinct Gut Microbiota Alterations</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/patients-with-early-vs-advanced-hcc-show-distinct-gut-microbiota-alterations"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Patients with early-stage hepatocellular carcinoma (HCC) and those with advanced-stage disease exhibited distinct gut microbiota diversity and alterations, with future studies warranted to investigate the mechanisms underlying the interactions between gut microbiota and HCC progression. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/dr-bruno-sangro-discusses-results-for-emerald-1-in-unresectable-hepatocellular-carcinoma"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/e48a3dbf1c3f77c6ea38a260fa072647ff9a10f9-665x195.png?fit=crop&auto=format" alt="Dr Bruno Sangro Discusses Results for EMERALD-1 in Unresectable Hepatocellular Carcinoma" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">January 19th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/dr-bruno-sangro-discusses-results-for-emerald-1-in-unresectable-hepatocellular-carcinoma">Dr Bruno Sangro Discusses Results for EMERALD-1 in Unresectable Hepatocellular Carcinoma</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/produced-by-mary-caffrey">Produced by Mary Caffrey</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/dr-bruno-sangro-discusses-results-for-emerald-1-in-unresectable-hepatocellular-carcinoma"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The study’s senior author discusses how the combined mechanisms of action produced benefit in progression-free survival.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/emerald-1-durvalumab-and-bevacizumab-plus-tace-improves-pfs-in-patients-with-unresectable-hcc"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/e48a3dbf1c3f77c6ea38a260fa072647ff9a10f9-665x195.png?fit=crop&auto=format" alt="EMERALD-1: Durvalumab and Bevacizumab Plus TACE Improves PFS in Patients With Unresectable HCC" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">January 19th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/emerald-1-durvalumab-and-bevacizumab-plus-tace-improves-pfs-in-patients-with-unresectable-hcc">EMERALD-1: Durvalumab and Bevacizumab Plus TACE Improves PFS in Patients With Unresectable HCC</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/mary-caffrey">Mary Caffrey</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/emerald-1-durvalumab-and-bevacizumab-plus-tace-improves-pfs-in-patients-with-unresectable-hcc"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">One expert said the results have the potential to change the standard of care for some patients with the most common type of liver cancer.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-19"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/camrelizumab-with-chemo-before-surgery-shows-superior-responses-over-chemo-in-locally-advanced-escc"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/e48a3dbf1c3f77c6ea38a260fa072647ff9a10f9-665x195.png?fit=crop&auto=format" alt="ASCO GI logo" width="288" class="jsx-ad50481d5ee26850 w-full xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 font-bold article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">January 18th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/camrelizumab-with-chemo-before-surgery-shows-superior-responses-over-chemo-in-locally-advanced-escc">Camrelizumab With Chemo Before Surgery Shows Superior Responses Over Chemo in Locally Advanced ESCC</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#000] text-sm italic" href="/authors/mary-caffrey">Mary Caffrey</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/camrelizumab-with-chemo-before-surgery-shows-superior-responses-over-chemo-in-locally-advanced-escc"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The PD-1 inhibitor is being studied in multiple cancers; FDA is reviewing an application of a combination with rivoceranib in unresectable hepatocellular carcinoma.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div><div class="w-full text-center flex justify-center pb-24"><a class="px-4 py-2 border-y border-r bg-primary text-white" href="/compendium/liver-cancer?page=1">1</a><a class="px-4 py-2 border-y border-r " href="/compendium/liver-cancer?page=2">2</a><a class="px-4 py-2 border-y border-r" href="/compendium/liver-cancer?page=2">></a></div></div></div><div class="flex-none w-[300px] z-[9999] relative hidden md:block"><div style="top:5rem" class="sticky custom-spacing"><div 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Sarah Manes, liver cancers program director of the ","_key":"68b92c9ca17b0","_type":"span"},{"marks":["dd5edf203730"],"text":"Global Liver Institute (GLI)","_key":"99b54355d3fc","_type":"span"},{"_type":"span","marks":[],"text":", delves into the critical issue of how bias—whether conscious or unconscious—between providers and patients can inhibit trust, hinder communication, and ultimately compromise care. ","_key":"1b3a3454dec3"}]},{"children":[{"_type":"span","marks":[],"text":"","_key":"04479329801a"}],"_type":"block","style":"normal","_key":"9cfabedb2aad","markDefs":[]},{"_key":"935c4bb5d148","markDefs":[],"children":[{"_type":"span","marks":[],"text":"In this interview, Manes explores the unique challenges faced by LGBTQI+ individuals, particularly those with disabilities, in accessing and receiving appropriate liver care. She sheds light on how financial barriers and a lack of competent, empathetic health care can lead to devastating gaps in treatment, raising urgent questions about equity and inclusion in the health care system.","_key":"ce4254818c76"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"0254c5d2f45f"}],"_type":"block","style":"normal","_key":"c65368599f33"},{"children":[{"_type":"span","marks":["em"],"text":"This transcript has been lightly edited for clarity.","_key":"b78cc50a61d9"}],"_type":"block","style":"normal","_key":"49da61d99798","markDefs":[]},{"markDefs":[],"children":[{"_key":"2236cada6d38","_type":"span","marks":["strong","underline"],"text":"Transcript"}],"_type":"block","style":"normal","_key":"8cc99f0aa769"},{"children":[{"text":"","_key":"c86a11a4dfee","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"2616133362b4","markDefs":[]},{"_key":"a63efcb67c57","markDefs":[],"children":[{"_key":"5411b4458eff0","_type":"span","marks":["strong"],"text":"What are some common barriers LGBTQI+ patients face when seeking care for liver-related issues?"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"One of the most common things we see truly comes down to the health care bias. You know, what does it look like if providers have a bias towards marginalized populations, and how does that end up affecting the patient and the provider relationship? If there is bias that's coming from a patient who's not comfortable answering the questions, and equally, if the provider isn't comfortable asking the right questions, what does that do to the LGBTQI+ population and really instilling trust and open conversation?","_key":"5b93584c30dd0"}],"_type":"block","style":"normal","_key":"3972419eb750","markDefs":[]},{"_type":"block","style":"normal","_key":"5bcb8793a39d","markDefs":[],"children":[{"marks":[],"text":"","_key":"a27f1f9ffbbc","_type":"span"}]},{"children":[{"_type":"span","marks":[],"text":"Also, looking into disability bias, some research has found that LGBTQI+ patients experience a higher rate of reported disabilities than their heterosexual counterparts. Why is that? Is it that bias that's coming from a provider that is maybe asking questions in a different way that they're not doing to their heterosexual patients? How do we continue to explore that? ","_key":"6bce49a6c91f"}],"_type":"block","style":"normal","_key":"14fe113c61be","markDefs":[]},{"_key":"0ce63feed8d4","markDefs":[],"children":[{"marks":[],"text":"","_key":"e7d2497a88fe","_type":"span"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"I also think talking about the cost-of-care barriers, oftentimes with transgendered people, in one of the studies that we looked at, 42% of them who are disabled and 30% of nondisabled said, due to financial barriers, within that 1-year period of time, they didn't seek any health care expertise or follow-up. So when we look at liver-related issues and having ongoing care, what happens when you're not going for that year of follow-up or even to get the liver disease diagnosis in the first place? 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What were the main findings, and how might these disparities be addressed?","_key":"60321ef19e6c0"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"b04737e830a3"}],"_type":"block","style":"normal","_key":"51cf4f2d7a26"},{"markDefs":[{"href":"https://www.ajmc.com/view/dr-amit-singal-on-unmet-needs-in-hcc-shifts-in-at-risk-populations","_key":"2b2e8765ad98","nofollow":false,"blank":true,"_type":"link"}],"children":[{"_type":"span","marks":[],"text":"So this goes back to ","_key":"a5ac596c6730"},{"marks":["2b2e8765ad98"],"text":"the point that we just discussed ","_key":"0bcf56844a73","_type":"span"},{"text":"in terms of the underuse of screening, as well as the underuse of treatment. And unfortunately, that underuse is not evenly distributed across society. ","_key":"16c7f6213e79","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"1bad177a5ac7"},{"markDefs":[],"children":[{"_key":"65a8eaf91ae8","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"38d1c92f965f"},{"children":[{"_type":"span","marks":[],"text":"We know that there are some subgroups which have higher proportions of underuse, and so the study that you're referencing discusses the underuse of therapy in different segments of society, looking at race and ethnicity specifically. We found, using a systematic review of the literature, that Black patients compared to White patients had lower odds of any treatment, as well as lower odds of curative therapy, and Hispanic patients had lower odds of curative therapy compared to non-Hispanic Whites—really showing that these segments of the population, unfortunately, are disproportionately impacted by treatment underuse. This partly explains why HCC-related mortality is higher in these subgroups compared to non-Hispanic Whites. Unfortunately, we see similar findings when we take a look at underuse of HCC screening, amongst other factors along that treatment cascade.","_key":"15b14e0e441a"}],"_type":"block","style":"normal","_key":"46d8cbdea55e","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"98c6ce818359"}],"_type":"block","style":"normal","_key":"856afb401095"},{"markDefs":[],"children":[{"_key":"add6ee45576d","_type":"span","marks":[],"text":"I have to say that it's easier to find these disparities and report these disparities, and it's been a taller task when you think of interventions that can address disparities—although that's clearly what we need to do as the next step. When we think through why these disparities exist, these disparities exist for multiple different reasons. This can be at the patient level, provider level, system, and community level. So when we think through this, we really need to think through multilevel interventions that will make patients more comfortable, more engaged with health care. We need to address other issues like transportation, financial barriers that exist in our current health care system. We need to address very difficult issues of provider implicit bias. We need to address some of the community-level barriers, like the ability to go out and feel safe in your neighborhood, the ability to have access to healthy foods and health care locally, so you don't have to drive 50 miles to a multidisciplinary setting to receive good HCC care. "}],"_type":"block","style":"normal","_key":"f3643803e739"},{"_key":"7eb108ac4156","markDefs":[],"children":[{"marks":[],"text":"","_key":"03448d7a9539","_type":"span"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Clearly, these interventions, once again are easier for me to list out and describe here. 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","_key":"4ff78811d64b"}],"_type":"block","style":"normal","_key":"3a6977f96b8f"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"6fd86592b4b3"}],"_type":"block","style":"normal","_key":"7dcf0095d110"},{"children":[{"text":"Transcript","_key":"9ab2bf2d37f8","_type":"span","marks":["strong","underline"]}],"_type":"block","style":"normal","_key":"ba85e7505f39","markDefs":[]},{"markDefs":[],"children":[{"text":"What gaps need to be addressed to improve equity and access to care for patients with liver cancer?","_key":"4505cd646dd60","_type":"span","marks":["strong"]}],"_type":"block","style":"normal","_key":"ed62202642f2"},{"markDefs":[],"children":[{"text":"One of the most critical aspects of the best outcome for any patient across any demographics is really getting a multidisciplinary evaluation because we have many therapies for cancer and liver cancer. We have surgeries, ablations, locoregional therapies that involve vascular delivery of therapies, and then we have systemic therapies, and of course, transplant as well—and I don't think any one clinician can know for certain whether one or another strategy is absolutely the best for a particular patient, and whether to discount any. ","_key":"08f5492cbd0d0","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"c4db730984bc"},{"children":[{"_type":"span","marks":[],"text":"","_key":"51b710822922"}],"_type":"block","style":"normal","_key":"bf07271a9a50","markDefs":[]},{"markDefs":[],"children":[{"_key":"87ae62621ab2","_type":"span","marks":[],"text":"There are some obvious metrics: if you have very advanced disease, you're not going to be a transplant candidate, for example. I think it's still very helpful for people to get that multidisciplinary evaluation of some sort. It doesn't necessarily have to be in a particular clinic, doesn't have to necessarily be a conference, but that just discussions have been held—and obviously taking into account patient preferences as well, and their comorbidities. That's really going to drive outcomes. "}],"_type":"block","style":"normal","_key":"9d0a36a92c7f"},{"style":"normal","_key":"5c9c7970c339","markDefs":[],"children":[{"text":"","_key":"b87908a18bb9","_type":"span","marks":[]}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"One of the problems is many people don't have access to all of those opinions, and I think that's really where the effort needs to be put into. 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And as novel therapies are utilized, oncologists should educate patients on the potential toxicities of different systemic therapies. ","_key":"7ab8b5648e20","_type":"span"}],"_type":"block","style":"normal","_key":"4da9165ef3b7"},{"style":"normal","_key":"4331da9f8fb0","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"1e747bed1ba4"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":["strong","underline"],"text":"Transcript","_key":"e33532c4ccb0"}],"_type":"block","style":"normal","_key":"3a2d9cec0176"},{"_type":"block","style":"normal","_key":"932f4498a1f2","markDefs":[],"children":[{"text":"How do you manage toxicities when treating patients with hepatocellular carcinoma, and are there any special considerations with novel therapies?","_key":"bce3b48bb8c50","_type":"span","marks":["strong"]}]},{"style":"normal","_key":"15c7ccc00fb2","markDefs":[],"children":[{"_type":"span","marks":[],"text":"For somebody that focuses on this area, this is a rapid learning curve, because for a long time, we've been used to managing the kinase inhibitor toxicities—the hypertension, proteinuria, hand-foot syndrome, oral lesions, diarrhea, and fatigue—and our staff has gotten pretty good at that. And we use these drugs in a lot of other cancers, so I think oncologists at large have a way of managing them. We're not perfect, and people still often need dose reductions, but we can often keep people on therapy, and that's likely to be how they're going to get the greatest benefit. ","_key":"e57132313c7f0"}],"_type":"block"},{"style":"normal","_key":"178d26cb8f5e","markDefs":[],"children":[{"_key":"2c1d523d43af","_type":"span","marks":[],"text":""}],"_type":"block"},{"style":"normal","_key":"e2c0cbe60246","markDefs":[],"children":[{"marks":[],"text":"With the checkpoint blockade, the immune therapies, there's a whole new group of toxicities that we're having to consider now. Of course, we do have experience across a variety of other cancers where we're using these drugs, so I think many oncologists are comfortable with them. 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","_key":"d07f7cb0e5530"},{"_type":"span","marks":["16a2f85db804"],"text":"hepatocellular carcinoma","_key":"53b4f12c7d25"},{"_type":"span","marks":[],"text":" (HCC), when screening is needed, and key tools in HCC surveillance and screening.","_key":"3c44b1ad8a50"}],"_type":"block","style":"normal","_key":"bdec35158be7"},{"_type":"block","style":"normal","_key":"9f64ab200f7a","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"0b207d54023f"}]},{"_key":"b370b48a5921","markDefs":[],"children":[{"_type":"span","marks":["strong","underline"],"text":"Transcript","_key":"747f8e78fd89"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"What populations are at the highest risk for HCC, and when should patients be screened?","_key":"172a5b3ab15d0"}],"_type":"block","style":"normal","_key":"7ee8d0eeee22"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"We have identifiable patient populations that have a very high risk for HCC. One of the most common globally is the presence of chronic hepatitis B, and there are high-risk subgroups of those with chronic hepatitis B. We used to define those using demographics—for example, older male, older female—but we've now moved into risk calculators that nicely capture several of these different factors. ","_key":"b1408d3e0e940"}],"_type":"block","style":"normal","_key":"50b970dac25c"},{"_key":"cdbc56186303","markDefs":[],"children":[{"_type":"span","marks":[],"text":"One of the best validated risk calculators among those with chronic hepatitis B is something called the PAGE-B score, which incorporates platelet count, age, gender, and then gives you a score that's a continuous nature. If you have a score of 10 or greater, you have a sufficiently high risk of HCC that you warrant HCC screening. In the Western world, it's moreso the presence of underlying cirrhosis, and that can be due to any one of several different etiologies, whether that's viral hepatitis, or nonviral etiologies. The common viral hepatitis etiologies are chronic hepatitis B and chronic hepatitis C. And then the most common nonviral etiologies include alcohol, and something that used to be called nonalcoholic fatty liver disease and is now called metabolic dysfunction–associated steatotic liver disease, or MASLD for short.","_key":"6f26b0cb23a9"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"c0cd70855a58"}],"_type":"block","style":"normal","_key":"704f10b8be0f"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Prevention and surveillance in HCC have been focuses of your research. What are some of the key tools in both of these areas that clinicians should be implementing?","_key":"163ae7113fc20"}],"_type":"block","style":"normal","_key":"675752257e59"},{"style":"normal","_key":"8848264bb305","markDefs":[],"children":[{"_type":"span","marks":[],"text":"When we think of prevention, I think it really goes back to those underlying etiologies. From a prevention perspective, it's identifying those with chronic viral hepatitis and treating them appropriately. So, for many patients with chronic hepatitis B, we have very effective medications that can suppress the chronic hepatitis B and significantly reduce the risk of developing HCC. For those who have chronic hepatitis C, we have very efficacious regimens, which can now cure you from hepatitis C with very short treatment regimens of 2 to 3 months. ","_key":"db050ea4b7350"}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"When we think through either alcohol-related liver disease or metabolic dysfunction–associated liver disease, we can also counsel our patients on either alcohol abstinence or at least sort of minimizing alcohol use. And then for those with metabolic dysfunction, we can work with our patients on weight loss, control of the the metabolic syndrome, including diabetes, which can also reduce the risk of liver disease progression and the risk of HCC. ","_key":"81aa2796a933"}],"_type":"block","style":"normal","_key":"fd42e2382c45","markDefs":[]},{"style":"normal","_key":"98bddd5dcfa2","markDefs":[],"children":[{"_type":"span","marks":[],"text":"I think when we think of this, it goes back to that Ben Franklin adage: An ounce of prevention is worth a pound of cure.vI think that's really where we need to spend a lot of our efforts is prevention of chronic liver disease and prevention of HCC. ","_key":"f55dbb3c9e94"}],"_type":"block"},{"style":"normal","_key":"e0ef7fb20faa","markDefs":[],"children":[{"_key":"93c88586ef87","_type":"span","marks":[],"text":"When we think through screening, or secondary prevention, we also have good strategies that we can implement in those at-risk individuals who have already progressed to chronic hepatitis B or the presence of cirrhosis. We typically recommend semiannual surveillance using abdominal ultrasound with or without a blood test called alpha fetoprotein. When we have those patients, it's important for us as clinicians to identify those patients, discuss the risk of HCC, and then to routinely do this every 6 months."}],"_type":"block"}],"_id":"4e9f9506-bafd-40aa-b75d-f6dc5e3292a1","summary":"Amit Singal, MD, medical director of the UT Southwestern Medical Center Liver Tumor Program, discusses populations at the highest risk of hepatocellular carcinoma (HCC), when screening is needed, and key tools in HCC surveillance and screening. 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Most people with hepatocellular carcinoma will have cirrhosis. You can get cirrhosis by having hepatitis C infection, hepatitis B—although hepatitis B can sometimes cause hepatocellular carcinoma without cirrhosis—alcohol misuse, some inherited syndromes, and of course the one that's becoming quite a bit more common now: metabolic-associated steatohepatitis, MASH. People used to know it is NASH [nonalcoholic steatohepatitis]. Of course, there are many people that have more than one of these risk factors. But the reality is that they are the causes of most of the hepatocellular carcinoma really worldwide, if you look at those different causes.\n\nThere's a small percentage of people that don't appear to have an obvious etiology. We really don't know why those people have hepatocellular carcinoma. But if you look at those that cause cirrhosis, they all essentially cause damage to hepatocytes; there's an attempt at regeneration, there's inflammation, and that environment leads to more damage. And eventually, you get outgrowth of dysplastic nodules, and then eventually invasive hepatocellular carcinoma.\n\nNow, the question that we've had now that we have more effective therapies is, is there a therapy that fits a particular etiology? And this is a very controversial area. My take on it is, there really isn't a particular therapy for a particular etiology. Most of the data comes from subgroup analyses from the individual trials. And although you can come up with biologic explanation why a particular etiology might lead to a therapy that's more effective for that, the reality is, it's not been consistent.\n\nWe do see some interesting observations. Hepatitis B patients tend to do better in general with the immune therapies. But really, you can look across the board and we really choose therapies more for what seems more appropriate based on other clinical considerations; certain other risk factors for bleeding, for example; risk of autoimmune events; whether people have had transplant before; patient choice; convenience; and so on—but not so much the etiology.\n"}],"_type":"block","style":"normal","_key":"6c2b475af58c","markDefs":[]},{"_key":"b3b84bc83f7c","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"70aa16884659"}],"_type":"block","style":"normal"},{"children":[{"marks":["strong"],"text":"Can you speak to the need for including patients with HCC of viral origin and those with HCC of non-viral origin in clinical trials?","_key":"a2eb4e8a2419","_type":"span"},{"_type":"span","marks":[],"text":"\nRight now, clinical trials in HCC, pretty much take any etiology of hepatocellular carcinoma and allow those people to participate if they meet the other inclusion criteria, and I think that's still important, because the reality, is we have a worldwide problem with hepatocellular carcinoma. It's obviously even a bigger problem in parts of Asia and Africa, but it really is a worldwide problem. And it's important to have patients that have different etiologies and different demographics included in the studies.\n\nThere's obviously been some discussion about when you design those studies, making sure you have adequate representation from different groups and then stratifying, if necessary, based on certain factors. But we're still faced with the fact that the most important prognostic factors are things like stage, which is partly reflected in portal vein invasion or extrahepatic spread, and Child-Pugh function, although most studies enroll only Child-Pugh A liver function. But those are the most important.\n\nBecause of different practice patterns in different parts of the world, you will often find stratifications based on where patients come from—Asia vs rest of the world, Japan vs the rest of the world. But I still come back to, as long as the study includes some attempt to enroll patients from different parts of the world with different demographics and different etiologies, that is what's most important.\n","_key":"be89d642fa9c"}],"_type":"block","style":"normal","_key":"e171ef21ed09","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"\n","_key":"9508a8bad2f8"},{"_type":"span","marks":["strong"],"text":"With most trials enrolling only patients with Child-Pugh A liver function, how do you approach treatment for those with Child-Pugh B liver function?","_key":"ac4d0d980930"},{"_type":"span","marks":[],"text":"\nYou're correct that most clinical trials only enroll patients with Child-Pugh A liver function. They certainly have much longer survival across the board, regardless of how you treat them. Prognostically, being Child-Pugh A, or preserved liver function, is better than Child-Pugh B. Child-Pugh C is controversial because those are often patients who die of their underlying liver dysfunction, even before the cancer is necessarily lethal to them.\n\nBut the Child-Pugh B population is quite large. In some centers, like mine, it approaches half of the patients, and in some it's maybe a quarter or a third, but there's a lot of them out there. And once again, the clinician is faced with how to manage them. Some drugs have been tested—not in randomized pivotal trials—but they've been tested in patients that have Child-Pugh B liver function, and more of these studies are planned. And we do know that it's true: They don't appear to survive as long as Child-Pugh A liver function patients, but they do seem to get benefit out of the various therapies that have been used.\n\nI think it's an important discussion with a patient: Why are they Child-Pugh B? Is it because they have a failing liver and it's rapidly failing, and they're crossing from A to B, on to C? Those people are better off trying to get anything that can be done to tune up their liver function, or palliative care. But maybe they’re Child-Pugh B because they've got a large burden of tumor, and so they really need the cancer treated and their liver function will improve. Let's take that scenario—we are certainly treating those people, even though they’re Child-Pugh B and even though there's limited data.\n\nThe other kind of data, though, that I think has been very instructive is those studies that have only enrolled Child-Pugh A patients, inevitably a fraction of those individuals will have a decline in their liver function. And we can look at that group—those that now have Child-Pugh B liver function, let's say 8 weeks into the study—and ask the question there, \"How do those patients fare?\"\n\nWe also see evidence—now obviously, this is in some cases retrospective evaluation—we see in those patients that they, too, get benefits just like the broader patient, that Child-Pugh A liver function patient, population does. So, I'm comfortable discussing treatment for Child-Pugh B liver function patients, and in most cases offering the same therapies. In some people where you're a little bit concerned, you might choose a different therapy, or instead of a combination, you might choose just one of the therapies. NCCN [National Comprehensive Cancer Network] Guidelines does deal with this. They mention certain drugs for just Child-Pugh A, they mention other drugs that could be for any patient regardless of their Child-Pugh function.\n","_key":"d3ac729e7bf2"}],"_type":"block","style":"normal","_key":"1dcbdc1b6846"}],"ExcludeFromPubMedXML":false,"articleType":"Commentary","thumbnail":{"asset":{"sha1hash":"507056674874b2d27e89a05c87fca380903696ff","path":"images/0vv8moc6/ajmc/507056674874b2d27e89a05c87fca380903696ff-624x346.png","_createdAt":"2024-04-12T18:10:03Z","_type":"sanity.imageAsset","assetId":"507056674874b2d27e89a05c87fca380903696ff","originalFilename":"Dr MIchael Morse 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You can connect with Rose on ","_key":"3abc796e3805"},{"text":"LinkedIn","_key":"123612bd9b2b1","_type":"span","marks":["a1a427c7e90e"]},{"_type":"span","marks":[],"text":".","_key":"123612bd9b2b2"}],"_type":"block","style":"normal"}],"profileImage":{"_type":"mainImage","alt":"Rose McNulty","asset":{"_ref":"image-8445b436ab605560bc20c7e9c6f4f60912e914df-430x430-png","_type":"reference"}},"_updatedAt":"2024-06-13T13:26:39Z","url":{"current":"rose-mcnulty","_type":"slug"},"firstName":"Rose","displayName":"Rose McNulty","_type":"author"}],"summary":"Michael Morse, MD, FACP, MHS, professor of medicine at Duke University School of Medicine and medical oncologist at Duke Cancer Center, spoke to the evolution of hepatocellular carcinoma (HCC) treatment in recent years, as well as ongoing research with potential to impact clinical practice.","body":[{"source":"brightcove","_key":"99a63b19565f","videoObject":{"thumbnail":{"asset":{"_ref":"image-db06462140bf8debe809df7db49ea59a74776755-490x273-png","_type":"reference"},"_type":"image"},"videoDuration":"PT8M23S","videoDescription":"Dr Michael Morse Discusses Current HCC Treatment Strategies and Future Directions","_type":"videoDetails","videoTitle":"Dr Michael Morse Discusses Current HCC Treatment Strategies and Future Directions"},"_type":"video","caption":"Michael Morse, MD, Duke Cancer Center","videoID":"6350334093112","disableAutoPlayVideo":false},{"_type":"block","style":"normal","_key":"748f37667c3b","markDefs":[],"children":[{"marks":[],"text":"Michael Morse, MD, FACP, MHS, professor of medicine at Duke University School of Medicine and medical oncologist at Duke Cancer Center, explained the evolution of hepatocellular carcinoma (HCC) treatment in recent years, as well as ongoing research with potential to impact clinical practice.","_key":"0717f475f0b70","_type":"span"}]},{"_key":"239c7af702e9","markDefs":[],"children":[{"text":"","_key":"e074a21df60a","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_key":"52ebb89136ae","_type":"span","marks":["strong","underline"],"text":"Transcript"}],"_type":"block","style":"normal","_key":"a999aa52ee5b"},{"_key":"170af70345d6","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"How has the treatment of HCC evolved over time, and how have novel treatment strategies impacted outcomes?","_key":"066bfb1110df0"}],"_type":"block","style":"normal"},{"_key":"c374eb7cabf5","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Well, HCC treatment has really changed dramatically. When I first started taking care of these patients in the late 1999 time point, it was chemotherapy, it was locoregional therapies, and that was pretty much it. And then we entered the tyrosine kinase era with sorafenib around 2007 or so. And for many years, there were other drugs that came along that were tested against sorafenib. But it took quite a while before even lenvatinib was shown to be noninferior for overall survival, but superior for some secondary end points. So now we had 2 tyrosine kinase inhibitors. ","_key":"ca7f7db7dee60"}],"_type":"block","style":"normal"},{"style":"normal","_key":"7ed57ed08123","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"be38f73fdf9b"}],"_type":"block"},{"_key":"538718f162f4","markDefs":[],"children":[{"_type":"span","marks":[],"text":"But the real advance has been the combinations with immune therapies—the anti–PD-1 and PD-L1 strategies or the combinations of anti–PD-1 and anti–CTLA-4. These have obviously increased survival and we now have higher response rates than we saw before. There are actually patients—they're uncommon—who even have complete responses or are downstaged enough that they can have other procedures done. So, we're really taking it from a uniformly fatal disease to one where there are some people who can have longer survivals than they had before.","_key":"c080418f2e24"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"0860ed9eaaea","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"3ea5570043f6"}]},{"markDefs":[],"children":[{"marks":["strong"],"text":"How has the emergence of combination and immunotherapies impacted\nHCC treatment?","_key":"ac33c98196100","_type":"span"}],"_type":"block","style":"normal","_key":"1fa23d0fb873"},{"_key":"21a9d859e30b","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Back in the beginning, we had the tyrosine kinase, or we can call them multikinase inhibitors, and they're used as single agents. And even when we had second-line multikinase inhibitors, they were still used as monotherapies. And then when immunotherapy came on the scene, again, it was monotherapy—we had nivolumab and pembrolizumab. But with combination therapies, we're now seeing longer overall survivals and higher response rates than we had previously seen before. So it offers the possibility that there are some patients who will survive a lot longer and will have enough disease control where they will be able to have additional procedures, maybe even get downstaged so that they can have a surgery or even a transplant. And that's really the direction the field has continued to go, is by putting these combinations together—whether it's checkpoint plus an anti-VEGF antibody or dual checkpoint inhibitors, or shortly we'll have approved a checkpoint plus a multikinase inhibitor.","_key":"429a0e6b52750"}],"_type":"block","style":"normal"},{"children":[{"_key":"dbcdc5789b0a","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"aaea457d0c13","markDefs":[]},{"_key":"d5725d8d9b58","markDefs":[],"children":[{"marks":["strong"],"text":"Are there any ongoing trials or potential new HCC treatment strategies you're excited about?","_key":"6a5c591e3ec80","_type":"span"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"d511267aa07b","markDefs":[],"children":[{"marks":[],"text":"Most of the research that's been ongoing, recently reported, and looking to the future has been looking at these different combinations. Is there a better or is there just another anti–PD-1 or PD-L1 that you can give with another immune checkpoint molecule, or a multikinase inhibitor plus immune checkpoint? ","_key":"e9ddede0153e0","_type":"span"}]},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"44534a0f4db4","_type":"span"}],"_type":"block","style":"normal","_key":"d2512e700770"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"What we have today is the atezolizumab plus bevacizumab combination— anti–PD-L1 plus an anti-VEGF antibody—and we have the durvalumab plus tremelimumab—the anti–PD-L1 plus anti–CTLA-4 antibody. We have, hopefully shortly to be FDA approved, the combination of an anti–PD-1 antibody, camrelizumab, plus a kinase inhibitor, rivoceranib. So that'll now give us more flexibility as we have another combination. Also recently—we haven't seen the data for this—but there is the report on a company website that the combination of an anti–PD-1, nivolumab, plus a different anti–CTLA-4, ipilimumab, has also shown activity, \"a positive study,\" in the front line. So it looks like we’re going to have at least 4 different possibilities for patients in the front line. ","_key":"6e2b2e311467"}],"_type":"block","style":"normal","_key":"9812839a6b26"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"41f188a14e90"}],"_type":"block","style":"normal","_key":"3ffdb63c09ea"},{"style":"normal","_key":"b5f58ba84b5b","markDefs":[],"children":[{"_type":"span","marks":[],"text":"What's really exciting are the attempts to expand this further. The combinations that I've mentioned could be used as platforms to then add additional therapies—additional checkpoint blockade, for example—against different targets. For example, there's a platform using atezolizumab plus bevacizumab that is now allowing other drugs to be added on, one of those being tiragolumab, that's shown some interesting activity in a small preliminary study.","_key":"8e687cc658d9"}],"_type":"block"},{"_type":"block","style":"normal","_key":"9d9a93392b9d","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"1325b03bc194"}]},{"children":[{"_type":"span","marks":["strong"],"text":"How is the treatment of HCC beyond the first line evolving?","_key":"4710d7c67d4b0"}],"_type":"block","style":"normal","_key":"ebe868ebae9e","markDefs":[]},{"markDefs":[],"children":[{"text":"I keep going back to when we started. When we started, very few people got systemic therapy. Finally, we had sorafenib, and then we had lenvatinib, and we had some other drugs that were being developed. And it just didn't even seem imaginable that people would get later lines of therapy, let alone the first line of systemic therapy. ","_key":"d6bfc82b31270","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"805609805f61"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"b8808f043cb0"}],"_type":"block","style":"normal","_key":"d8328a43b2a8"},{"_key":"421cc62807c3","markDefs":[],"children":[{"_type":"span","marks":[],"text":"But as new drugs were developed, they started to be tested in the second line. So, we had other multikinase inhibitors that showed a survival benefit. Keep in mind all of these studies, though, were done in people who had had sorafenib first. But in that setting, we had cabozantinib [show] survival benefit compared to placebo; regorafenib [show] survival benefit compared to placebo. Then we had ramucirumab that, at least in the AFP [alpha fetoprotein]-high population greater than 400 ng/mL, [showed] survival benefit compared to placebo. ","_key":"98f2009c2e2f"}],"_type":"block","style":"normal"},{"style":"normal","_key":"3f67671c19e7","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"cc2eb0f4cc40"}],"_type":"block"},{"_key":"7fb575ff4c8e","markDefs":[],"children":[{"text":"We also did have activity for immune checkpoint inhibitors. Now, these these were originally tested as in single-arm studies, like nivolumab and pembrolizumab, and they also appeared to have activity in terms of response rate and some interesting longer-term outcomes. Pembrolizumab did end up, in a randomized trial, did not meet its end point—but subsequently, there was a pembrolizumab trial that did meet its end point in an Asian population. ","_key":"c922c93a113b","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"8676ad8cb231"}],"_type":"block","style":"normal","_key":"49cc9d2bd7b9"},{"markDefs":[],"children":[{"_key":"8bcd9e063848","_type":"span","marks":[],"text":"So, we have a number of options. And then we also had combinations that were developed there, particularly nivolumab plus ipilimumab—again, not compared with placebo, just as a combination by itself. So, the problem being when all of this data, coming from patients who had previously had sorafenib, when we then reached the point that we were starting to use immune checkpoint inhibitors in the first line in these combination therapies—atezolizumab, bevacizumab, durvalumab, tremelimumab, for example—how do we interpret the data for second-line therapies? And this is still an open question right now. "}],"_type":"block","style":"normal","_key":"90a0c5ff9c47"},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"2429a223a52a","_type":"span"}],"_type":"block","style":"normal","_key":"236dd7c17154"},{"_type":"block","style":"normal","_key":"1e7f6df42eca","markDefs":[],"children":[{"marks":[],"text":"The clinical reality is you have to do what you have to do. So, if somebody progresses on one of these frontline options, you can really use one of any of these therapies in my opinion. None of them have been directly compared with each other. Some individuals will choose to shift the paradigm over, so your second line could essentially be use of one of the first-line multikinase inhibitors, lenvatinib and sorafenib. Or you could choose the \"established\" second-line options and just say, \"Well, we don't have as much data after these new frontline combinations, but these are viable second-line options.\" ","_key":"edb552ad9683","_type":"span"}]},{"children":[{"text":"","_key":"5c9ce6073f8f","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"78729cb8dd36","markDefs":[]},{"style":"normal","_key":"5fe6b8855bf3","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Honestly, any of those is fine, however people prefer to practice. A lot of it has to do with comfort level with the different therapies. They do have some slight differences in their targets, and you might choose one based on the particular targeting that you think might be relevant to that patient. We are now starting to get these second-line studies. There's an innovative study coming from a community plus academic cooperative group that's taking people who have had atezolizumab plus bevacizumab and randomizing them to continuing the atezolizumab with either one of the tyrosine kinase inhibitors or just using one of the tyrosine kinase inhibitors in the second line. So we're going to start to get this type of data, but for right now, the clinician facing this really has a lot of options—but not a lot of data—in our current scenario.","_key":"ab52ecbc1196"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"ff7e1e43c26e"}],"_type":"block","style":"normal","_key":"6ed61bdb1153"}],"contentCategory":{"_type":"contentCategory","name":"Videos","_id":"ee14ccb3-3542-4414-9046-927be1198c76","_updatedAt":"2020-04-03T20:03:44Z","_createdAt":"2020-04-03T20:03:44Z","_rev":"Yw6MEKZDMdk6hC2JCPjfiB"},"ExcludeFromPubMedXML":false,"source":null,"_id":"ad441195-c814-4545-be7c-34640fb2e225"}],"topArticlesData":[{"source":null,"factCheckAuthors":null,"title":"FDA OKs Study of Amezalpat in Frontline Liver Cancer","thumbnail":{"_type":"mainImage","alt":"Liver cancer | Image credit: Rasi - stock.adobe.com","asset":{"_ref":"image-5ffaa2b7f4832daefa4cbc2a2879fa226475d0c1-4200x2400-jpg","_type":"reference"}},"summary":"The FDA approved a phase 3 trial to assess amezalpat with the current standard of care in unresectable or metastatic hepatocellular carcinoma.","published":"2024-11-21T15:19:39.191Z","updatedOn":null,"_id":"eca78ebe-16ea-49d1-9059-a3e855791c8d","url":"fda-oks-study-of-amezalpat-in-frontline-liver-cancer","authors":[{"displayName":"Jordyn Sava","url":"jordyn-sava"}]},{"updatedOn":null,"thumbnail":{"_type":"mainImage","alt":"Woman holding a representation of a liver | Image credit: LIGHTFIELD STUDIOS - stock.adobe.com","asset":{"_ref":"image-3b2aadaa4bd3856f8b6bc28898a494f1fb4fffcd-1200x801-jpg","_type":"reference"}},"title":"Liver Cancer Risk Assessments: New Tool Beats Standard Screening","url":"liver-cancer-risk-assessments-new-tool-beats-standard-screening","summary":"A new risk score model for hepatocellular carcinoma using standard clinical data can better identify individuals at risk better than the current standard risk models. 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