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Hepatocellular Carcinoma Update, Issue 1, 2017 (Video Program)
Released July 2017

Highlights from video interviews with Drs Anthony El-Khoueiry and Josep M Llovet on the treatment of hepatocellular carcinoma.

CE Disclosures and Faculty Information

    This activity is intended for medical oncologists, radiation oncologists and other healthcare providers involved in the treatment of hepatocellular carcinoma (HCC).

    HCC, the most common form of liver cancer, is the third leading cause of cancer-related death worldwide. The rising incidence, multiple etiologies, genetic heterogeneity and concurrent chronic liver disease challenge the selection of treatment for patients with this cancer. HCC is often diagnosed in the advanced stage and as such is associated with a poor prognosis. Recent breakthroughs in the understanding of the etiology and pathogenesis of HCC have led to the advent of new treatment modalities and investigational therapies, and in order to offer optimal patient care, the practicing oncologist must be well informed of these advances. To bridge the gap between research and patient care, this issue of Hepatocellular Carcinoma Update uses one-on-one discussions with leading oncology investigators. By providing access to the latest research developments and expert perspectives on the disease, this CME program will assist medical oncologists and gastroenterology specialists in the formulation of up-to-date clinical management strategies for HCC.


    • Appraise available clinical trial data guiding the use of systemic therapies for patients with advanced HCC.
    • Review the efficacy and safety data with regorafenib, and formulate a plan to incorporate this information into the treatment of HCC in patients who experience disease progression on sorafenib.
    • Understand the scientific rationale for and recall available clinical data with investigational immune checkpoint inhibitors in the treatment of HCC.
    • Recall available and emerging data with other investigational agents currently in clinical trials for HCC, and counsel appropriately selected patients about trial participation.

    Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

    CME credit is no longer available for this issue

    CME credit is no longer available for this issue

    This CME activity consists of a video component.
    CME credit is no longer available for this issue

    Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess conflicts of interest with faculty, planners and managers of CME activities. Conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

    FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

    Anthony El-Khoueiry, MD
    Associate Professor of Clinical Medicine
    Medical Director of Clinical Investigations Support Office
    Phase I Program Director
    USC Norris Comprehensive Cancer Center
    Los Angeles, California

    Advisory Committee: AstraZeneca Pharmaceuticals LP; Consulting Agreements: Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Celgene Corporation, CytomX Therapeutics, Genentech BioOncology, Transgene.

    Josep M Llovet, MD, PhD
    Professor of Medicine
    Director, Mount Sinai Liver Cancer Program
    Division of Liver Diseases, Tisch Cancer Institute
    Icahn School of Medicine at Mount Sinai New York
    New York, New York
    Professor of Research — ICREA
    Director, Master in Translational Medicine
    BCLC Group, Liver Unit, IDIBAPS
    CIBERehd, Hospital Clínic de Barcelona
    University of Barcelona
    Barcelona, Spain

    Advisory Committee: Bayer HealthCare Pharmaceuticals; Consulting Agreements: Bayer HealthCare Pharmaceuticals, Blueprint Medicines, Lilly; Contracted Research: Bayer HealthCare Pharmaceuticals, Blueprint Medicines, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company.

    EDITOR — Dr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma Corp, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Medivation Inc, a Pfizer Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sanofi Genzyme, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, Teva Oncology and Tokai Pharmaceuticals Inc.

    RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no relevant conflicts of interest to disclose.

    This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

    This activity is supported by educational grants from Bayer HealthCare Pharmaceuticals and Bristol-Myers Squibb Company.

    Hardware/Software Requirements:
    A high-speed Internet connection
    A monitor set to 1280 x 1024 pixels or more
    Internet Explorer 7 or later, Firefox 3.0 or later, Chrome, Safari 3.0 or later
    Adobe Flash Player 10.2 plug-in or later
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio

    Last review date: July 2017
    Expiration date: July 2018

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Watch videos
(WIFI is recommended for best performance):

Efficacy of sorafenib and integration of the recently FDA-approved multikinase inhibitor regorafenib into the treatment algorithm for advanced hepatocellular carcinoma (HCC)

  • Recent advances in the management of HCC
  • Improvement in overall survival with sorafenib as first-line therapy for advanced HCC
  • Results of the placebo-controlled Phase III RESORCE trial evaluating the role of regorafenib for patients with HCC and disease progression after treatment with sorafenib
  • Clinical experience with and side-effect profiles of regorafenib and sorafenib
  • Case discussion: A 68-year-old woman with metabolic syndrome, diabetes and nonalcoholic steatohepatitis-related HCC receives transarterial chemoembolization (TACE) as first-line therapy
  • Case discussion: A 69-year-old man with a history of hepatitis C infection presents with a single 6-cm lesion and is diagnosed with HCC
  • TACE for patients with intermediate-stage HCC and well-preserved liver function; Barcelona Clinic Liver Cancer (BCLC) staging system and treatment schedule
  • Therapeutic options for patients with advanced HCC and macrovascular invasion
  • Available research data and ongoing trials in the second-line setting for HCC
  • Efficacy and toxicity profile of regorafenib as second-line therapy in the RESORCE trial; dose modifications and adjustments

Immune checkpoint inhibitors in the management of HCC: Biologic rationale and emerging data

  • Biologic rationale for the investigation of immune checkpoint inhibitors for HCC
  • Interim analysis of the Phase I/II CheckMate 040 trial evaluating the safety and antitumor activity of nivolumab in patients with advanced HCC
  • Durable objective responses to nivolumab in advanced HCC
  • Potential role of immune checkpoint inhibitors in the clinical management of HCC
  • Efficacy of anti-CTLA-4 antibodies alone and in combination with anti-PD-1 antibodies
  • Potential utility of immune checkpoint inhibitors in the management of HCC
  • Viewpoint on the potential integration of nivolumab into the treatment algorithm for HCC
  • Case discussion: A 71-year-old man with chronic hepatitis B infection is diagnosed with Child-Pugh A cirrhosis and BCLC Stage C HCC

Activity and tolerability of lenvatinib for patients with unresectable HCC

  • Phase III Study 304 comparing lenvatinib to sorafenib as first-line therapy for unresectable HCC
  • Activity and tolerability of lenvatinib for unresectable HCC

Management of local-regional disease

  • Case discussion: A 74-year-old man with chronic hepatitis B presents with a single lesion, is diagnosed with HCC and remains disease free 4 years after surgical resection