Immune-Based Combinations Are Reshaping Liver Cancer Treatment

Dr. Augusto Villanueva Rodriguez, medical director of the Liver Cancer Program at NYU Langone Health, explained that treatment for liver cancer looks very different than it did a decade ago. He noted that patients with advanced or metastatic disease previously had only one targeted therapy option, while today there are 10 FDA-approved drugs.

Rodriguez emphasized that immune-based therapy has become the foundation of systemic treatment. Three immune-based combinations have improved survival in the first-line setting, giving patients meaningful options at diagnosis of advanced disease.

He said response rates have climbed to about 30 to 35%, which was not imaginable 10 years ago. With more patients experiencing strong responses, clinicians are beginning to rethink management strategies. In some cases, he said, doctors are now considering curative approaches, such as surgery or local regional therapy, for patients who previously would not have been candidates.

He described the field as rapidly evolving, driven by the impact of immune-based therapies in advanced liver cancer.

Transcript

Can you discuss the major advancements in systemic therapy for liver cancer, including immunotherapy and targeted agents? How are they changing the treatment landscape?

Well, the treatment of liver cancer has changed dramatically in the last 10 years. Ten years ago, there was only one targeted agent approved and shown to be efficacious to improve survival in patients that have advanced stage or metastatic disease. Now we have 10 drugs approved by the FDA for the treatment of liver cancer. And I want to emphasize that the backbone today of systemic therapies for liver cancer relies on immune therapies. There are three immune-based combination therapies that have been shown efficacy to improve survival in the front line, meaning in patients that have been diagnosed with advanced stage, or have progressed to advanced stage, the first option will include immune-based therapy.

Now we see rates of response nearing 30, 35%, and this was unthinkable 10 years ago. So the number of patients that achieve a response with immune-based therapy is remarkable, and now we're at a point where we're reconsidering the entire management of liver cancer, meaning that with patients having such significant responses, we're thinking about applying curative therapies such as resection or local, regional therapies that, in the past were not applicable for patients at advanced stages. The whole field is changing thanks to the eruption of immune-based therapies in patients with advanced stage.

Transcript has been edited for clarity and conciseness.

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