Oncology Brothers: Practice-Changing Cancer Discussions

2nd line treatment in advanced HCC and when to switch

Dec 13, 2024

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In the second episode of a 4-part podcast series on HCC, the Oncology Brothers, Drs Rahul and Rohit Gosain, host a podcast discussion between Dr Lorenza Rimassa and Prof. Arndt Vogel on 2nd line treatment selection in advanced HCC and when to switch.

The discussion covers a range of topics, including 2nd line options for advanced HCC after progression on 1st line TKIs and IO-based therapies, as well as:

How to approach sequencing in clinical practice
The available data supporting sequencing strategies
When to switch to 2nd line therapy and what to consider when doing so

This is the second video podcast episode in a 4-part series. Access the rest of the series here:

Part 1 - The use of IO in unresectable HCC

Part 3 - Intermediate HCC: treatment options and strategies (coming soon)

Part 4 - The evolving role of IO in intermediate HCC (coming soon)

Clinical takeaways

Prospective Phase 3 data on 2nd line options in advanced HCC, particularly after immunotherapy, is limited, highlighting the need for further evidence to guide optimal treatment decisions
When switching to 2nd line therapy, it is essential to evaluate all the available treatment options to ensure the optimal choice for each patient, considering efficacy, tolerability, liver function, and quality of life.
Switching to 2nd line therapy should be considered in cases of clear disease progression, such as the appearance of new lesions outside the liver. Best supportive care should also be considered
Managing side effects of 2nd line treatments (e.g. hypertension, skin toxicity, proteinuria) is critical for maintaining quality of life and providing optimal disease management
Effective management requires a multidisciplinary team effort, including oncologists, hepatologists, interventional radiologists, and other specialists to optimise outcomes and proactively manage symptoms like hepatic decompensation.

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