New treatment options emerge for intermediate, advanced HCC

March 7, 2018|Hematology and Oncology

REPORTING FROM THE 2018 GI CANCERS SYMPOSIUM

SAN FRANCISCO – Two new therapies that target vascular endothelial growth factor signaling are efficacious and may expand the treatment armamentarium for intermediate and advanced hepatocellular carcinoma, data from a pair of randomized trials suggest.

In the phase 2 TACTICS (Transcatheter Arterial Chemoembolization Therapy in Combination With Sorafenib) trial, median progression-free survival, using a new, more narrow definition of progression, was almost a year longer when the oral tyrosine kinase inhibitor sorafenib (Nexavar) was added to transarterial chemoembolization (TACE) for unresectable hepatocellular carcinoma (HCC), translating to a 41% reduction in risk of events. This benefit came at the price of higher rates of certain grade 3 adverse events, but the combination was overall feasible and safe.

In the phase 3 CELESTIAL trial, median overall survival was about 2 months longer with the oral tyrosine kinase inhibitor cabozantinib(Cabometyx, Cometriq) than with placebo among patients with advanced HCC who had previously received sorafenib, translating to a 24% reduction in risk of death. The rate of grade 3 or 4 adverse events was about twice as high with cabozantinib, but treatment discontinuation because of events was uncommon.

Results of both trials were reported at the 2018 GI Cancers Symposium, sponsored by the American Gastroenterological Association, the American Society for Clinical Oncology, the American Society for Radiation Oncology, and the Society of Surgical Oncology.