The Challenges of Treating Liver Cancer

Richard Finn, MD, Division of Hematology/Oncology at the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, discusses the difficulties of treating liver cancer.

Finn says liver cancer is unique because it occurs with underlying liver disease and cirrhosis. Many drugs in this space have ignored underlying liver disease with the exception of sorafenib, which was the last liver cancer drug to be approved.

Sorafenib continues to be the standard when treating liver cancer because it was developed to minimize the effect of underlying liver disease. In the SHARP trial, Finn says, sorafenib improved the survival rate of patients with liver cancer compared to a placebo.

Since the SHARP trial, there have been many more phase III studies, but no new drugs have demonstrated superiority to sorafenib, Finn says.

Finn thinks that many antiangiogenic multikinase inhibitors could have shown benefit compared with placebo in frontline studies, but as sorafenib is the standard, it has been difficult to improve upon.

Clinical Pearls:

• Liver cancer is unique because it occurs with underlying liver disease and cirrhosis
• Sorafenib was the last liver cancer drug to be approved
• Sorafenib continues to be the medical standard when treating liver cancer because it minimizes the effect of underlying liver disease in patients
• No drugs have demonstrated superiority to sorafenib over the last several years