hepatocellular carcinoma

Yeah, so Matthias, I think it's a great question and a great place to start.

So when we think through HCC, we know that this is a cancer that unfortunately continues to currently have a poor prognosis overall, although there is a marked difference in terms of prognosis if one is found at an early stage versus more advanced stage.

And so this really underscores, honestly, the biggest premise of HCC surveillance in general.

And then when we go to look at the data, we can see that the data, albeit imperfect, are supported by a large randomized clinical trial in China over 20 years ago among patients with chronic hepatitis B.

So in brief, this trial randomized over 18,000 patients to receive HCC surveillance versus not in a sort of block randomization manner.

And the trial showed a 37% reduction in the risk of dying from HCC.

Now, we do not have randomized clinical data among patients with cirrhosis.

There was a large randomized clinical trial that was attempted in Australia years ago and had to be stopped prematurely because both patients and providers refused to enroll in the clinical trial, given the fact that they wanted to be randomized to the surveillance arm.

We've got a few questions for you.

Our first one to start, how do you decide between Atizo, Bev, Epi, Nevo and Stride in first-line therapy for unresectable HCC? Well, Lawrence, this is a

very topical question at the moment.

As you know, we haven't had much choice in Australia until very recently.

Our second question, what clinical or biological features push you towards dual IO therapy rather than IO therapy with anti-VEGF therapy?

So yeah, this is an extension of the previous question.

I think this is an area of active research to try and personalize systemic therapy for HCC.

And again, there's no robust biological data to say one type of tumor responds better to dual IO versus IO plus Bevacizumab.

A blood test can be ordered during routine visit and completed in the same familiar lab that patients already are using.

And we know from real-world evidence that, you know, uh, there is a study done among Medicare patients who later were diagnosed with HCC, which showed actually that only 21% of these people had received even one ultrasound in those three years, right? That's one.

So starting with ultrasound.

Then follow-through is another important, right? You, you, you have to come back every six months for life because you're at high risk for liver cancer, and that doesn't happen.

The last one that was presented, because a lot of doctors are very interested in the real world use of it, right, was a simulation study which was evaluating whether surveillance when HelioLiver is being used could increase the detection of tumor while they are still able to go for, you know, curative options, right? What's called early stage treatment category.

And that definitely is there.

And you know, all of this is only possible because the biology, the change in biology when you have liver cancer, when you have HCC, begins long before the tumor is large enough to be clearly visualized on imaging.

And this is one of the quotes of the doctor, right, who's involved in this.

I'm a PhD candidate in biochemical and neuromotor sciences at the University of Bologna.

Today, I would like to present my research project, which focuses on improving the surveillance and the early diagnosis of hepatocellular carcinoma, or HCC, in patients with liver cirrhosis.

Hepatocellular carcinoma is the most common primary liver cancer and represents a major global health challenge.

In fact, it accounts for about ninety percent of all primary liver cancers and is one of the leading causes of cancer-related death worldwide.

Most cases develop in patients with underlying cirrhosis, a chronic condition characterized by progressive liver fibrosis and impaired liver function.

One of the major problems with HCC is that it is usually asymptomatic in its early stages.

As a result, many patients are diagnosed only when the disease is already advanced and treatment options are limited.

Current surveillance programs generally recommend liver ultrasound, sometimes combined with alpha fetoprotein measurement, every six months for all patients considered at risk.

[outro music] The following podcast is part of a certified educational activity titled "Redefining Therapeutic Progress in Hepatocellular Carcinoma: Extending the Benefits of Immunotherapy to Earlier Stages of Disease." Access the entire activity and complete the post-test at peerview.com/PEH860.

Downloadable slides are also available.

Welcome everybody, and, uh, this is an educational program, Redefining Therapeutic Progress in HCC.

My name is Ghassan Abou-Alfa, GI medical oncologist at Memorial Sloan Kettering Cancer Center in New York City.

I'll be discussing the latest developments in regard to modern therapies for patients with HCC, including the new evidence arising from the twenty twenty-six ASCO annual meeting.

Let's begin with our educational goals for today.

During this presentation, we will learn together that evidence is rapidly emerging, supporting the use of immunotherapy for HCC in early stage disease.

It's essential to develop a personalized treatment plan that considers the latest data, clinical practice guidelines, and unique patient needs.