Hepatocellular carcinoma (HCC) is the fourth highest cause of cancer-related death globally. There is great geographical variation in the distribution of HCC, with an estimate of 72% cases found in Asia. Sorafenib and Lenvatinib have been widely used as the only available first-line standard systematic therapy for advanced HCC. Recently, a group of clinicians, economists, and patient advocates from the Asia-Pacific region (including Japan, Singapore, China, Korea, and Taiwan) came together to put forth recommendations on treatment options for patients with advanced HCC.
They note, for instance, that a novel combination treatment with atezolizumab and bevacizumab has shown significantly better outcomes than sorafenib. Atezolizumab + bevacizumab has the potential to replace lenvatinib and sorafenib as standard of care. However, such an expansion imposes challenges of treatment selection and sequence, and a further difficulty is presented by different healthcare systems and reimbursement guidelines across the Asia-Pacific region. New additions have led to improved survival, while making it more challenging for clinicians to determine the optimal way to sequence treatments.
Addressing these challenges will require considerations from all stakeholders—from patients to the involved government agencies. Regardless, the success of atezolizumab + bevacizumab in prolonging lives marks the beginning of a new era and provides a beacon of hope for HCC patients.