Highlights

• With HCC, the treatment is a multidisciplinary approach for the management, so essentially with patients who have localized disease, the main options are usually going to be either surgical management or ablative therapies… If the disease is localized and it is thought to be resectable, then that will often be the preferred management. If the disease is either unresectable or the patient may not be fit for surgery for whatever reason, then ablative therapies may be used in those cases. So, as an oncologist, we have a lesser role in those
  patients because there really is not good evidence of any role for downstaging systemic therapies or adjuvant systemic therapies in this particular disease.

   

• For those patients [who are going to be managed palliatively] we generally manage them with systemic agents if they are fit enough for systemic agents, and essentially the first line of treatment is TKI therapy with Nexavar, that has been the sort of gold standard for over a decade now, 12–13 years, that has been the standard of care.

   

• I think it will certainly have a positive impact in terms of this disease area, I think the likelihood is that immunotherapies will be shown to be effective. I think one of the main issues will be how to select patients because I would say that the chances of responding in the first-line setting with immunotherapy are probably going to be at best 20–25%. So, how do we identify those patients? Is there a good biomarker? I would say it is probably unlikely that PD-L1 status is going to be the best biomarker to predict responses. So, I would say that is going to be critical, but I think overall the use of Opdivo or other PD-1 or PD-L1 antibodies is likely to be shown effective in the first-line setting.