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

OVERVIEW OF ACTIVITY
HCC, the most common form of liver cancer, is the third leading cause of cancer-related deaths worldwide. The rising incidence, multiple etiologies, genetic heterogeneity and concurrent chronic liver disease make the selection of treatment for this cancer challenging. In addition, HCC is often diagnosed in the advanced stage and is associated with a poor prognosis. However, recent breakthroughs in understanding the etiology and pathogenesis have led to the advent of new treatment modalities and investigational therapies. 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 select gastroenterology specialists in the formulation of up-to-date clinical management strategies for patients with HCC.

LEARNING OBJECTIVES

• Consider patient age, performance status, liver function and other clinical and logistical factors in the up-front management of newly diagnosed unresectable or metastatic HCC.
• Appreciate the FDA approval of regorafenib for patients who have experienced treatment failure with sorafenib, and discern how regorafenib can be optimally integrated into clinical management.
• Appraise recent Phase III data with lenvatinib, and consider the clinical role of this agent in the management of previously untreated unresectable HCC.
• Recall available efficacy and safety data with cabozantinib, and consider the potential clinical role of this agent for patients who experience disease progression on sorafenib.
• Understand the scientific rationale for and recall available clinical trial data with approved and investigational checkpoint inhibitors in the treatment of HCC.
• Evaluate emerging Phase III data with ramucirumab in patients with advanced HCC and elevated alpha-fetoprotein who have experienced disease progression after treatment with sorafenib.

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

CREDIT DESIGNATION STATEMENT
CME credit is no longer available for this issue

AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
CME credit is no longer available for this issue

HOW TO USE THIS CME ACTIVITY
Audio Program: This CME activity consists of an audio component.
CME credit is no longer available for this issue

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

CONTENT VALIDATION AND DISCLOSURES
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:

Richard S Finn, MD
Assistant Professor of Medicine
Division of Hematology/Oncology
Dumont-UCLA Liver Cancer Center
Geffen School of Medicine at UCLA
Los Angeles, California

Advisory Committee: AstraZeneca Pharmaceuticals LP; Consulting Agreements: Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Eisai Inc, Exelixis Inc, Lilly, Merck, Novartis, Pfizer Inc, Roche Laboratories Inc.

Andrew X Zhu, MD, PhD
Director, Liver Cancer Research
Massachusetts General Hospital Cancer Center
Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Advisory Committee: AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Eisai Inc, Lilly, Merck, Novartis, Sanofi Genzyme; Contracted Research: Bayer HealthCare Pharmaceuticals, Lilly, Merck, Novartis.

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

RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent 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, Bristol-Myers Squibb Company, Eisai Inc and Lilly.

Hardware/Software Requirements:
A high-speed Internet connection
A monitor set to 1280 x 1024 pixels or more
Internet Explorer 11 or later, Firefox 56 or later, Chrome 61 or later, Safari 11 or later, Opera 48 or later
Adobe Flash Player 27 plug-in or later
Adobe Acrobat Reader
(Optional) Sound card and speakers for audio

Release date: October 2018
Expiration date: October 2019