A potentially practice-changing clinical trial for first line therapy is the first to show that the combination of two immunotherapy medications is an effective treatment for hepatocellular carcinoma (HCC). The HIMALAYA study evaluated combination immunotherapy (IO-IO), durvalumab with tremelimumab, as frontline therapy in patients with unresectable HCC. Overall survival was significantly improved with the IO-IO combination compared with sorafenib monotherapy (16.4 vs 13.8 months; hazard ratio [HR], 0.78; 96% CI, 0.65-0.92; P =.0035).
Early results of the phase three LAUNCH trial are also promising. This trial compared the combination of lenvatinib with transarterial chemoembolization (TACE) to lenvatinib alone in an Asian population with advanced HCC. The lenvatinib-TACE group achieved a higher median overall survival (17.8 vs. 11.5 months and median progression-free survival (10.6 vs. 6.4 months).
Muhammad Shaalan Beg, MD, director for GI Medical Oncology at UT Southwestern Medical Center in Dallas summarizes these and other takeaways from emerging research on advanced HCC presented at the recent ASCO GI Symposium.