Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of hepatocellular carcinoma
Journal
Journal for ImmunoTherapy of Cancer
Journal Volume
9
Journal Issue
9
Date Issued
2021
Author(s)
Greten T.F.
Abou-Alfa G.K.
Duffy A.G.
El-Khoueiry A.B.
Finn R.S.
Galle P.R.
Goyal L.
He A.R.
Kaseb A.O.
Kelley R.K.
Lencioni R.
Lujambio A.
Mabry Hrones D.
Pinato D.J.
Sangro B.
Troisi R.I.
Wilson Woods A.
Yau T.
Zhu A.X.
Melero I.
Abstract
Patients with advanced hepatocellular carcinoma (HCC) have historically had few options and faced extremely poor prognoses if their disease progressed after standard-of-care tyrosine kinase inhibitors (TKIs). Recently, the standard of care for HCC has been transformed as a combination of the immune checkpoint inhibitor (ICI) atezolizumab plus the anti-vascular endothelial growth factor (VEGF) antibody bevacizumab was shown to offer improved overall survival in the first-line setting. Immunotherapy has demonstrated safety and efficacy in later lines of therapy as well, and ongoing trials are investigating novel combinations of ICIs and TKIs, in addition to interventions earlier in the course of disease or in combination with liver-directed therapies. Because HCC usually develops against a background of cirrhosis, immunotherapy for liver tumors is complex and oncologists need to account for both immunological and hepatological considerations when developing a treatment plan for their patients. To provide guidance to the oncology community on important concerns for the immunotherapeutic care of HCC, the Society for Immunotherapy of Cancer (SITC) convened a multidisciplinary panel of experts to develop a clinical practice guideline (CPG). The expert panel drew on the published literature as well as their clinical experience to develop recommendations for healthcare professionals on these important aspects of immunotherapeutic treatment for HCC, including diagnosis and staging, treatment planning, immune-related adverse events (irAEs), and patient quality of life (QOL) considerations. The evidence- and consensus-based recommendations in this CPG are intended to give guidance to cancer care providers treating patients with HCC. ? Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Subjects
antineoplastic protocols; guidelines as topic; immunotherapy; liver neoplasms
SDGs
Other Subjects
atezolizumab; bevacizumab; cancer vaccine; immune checkpoint inhibitor; ipilimumab; nivolumab; pembrolizumab; sorafenib; tumor marker; abdominal pain; adrenal insufficiency; arthralgia; aseptic meningitis; autonomic neuropathy; body weight gain; body weight loss; bone marrow depression; cancer immunotherapy; cancer staging; chest tightness; colitis; cytopenia; diarrhea; drug efficacy; drug induced disease; drug safety; dry cough; dyspnea; encephalitis; erythema multiforme; fatigue; fever; Graves disease; Guillain Barre syndrome; headache; hemolytic anemia; hemophagocytic syndrome; hemophilia A; hepatitis; histology; human; hyperthyroidism; hypophysitis; hypothyroidism; jaundice; liver cell carcinoma; liver imaging reporting and data system; liver toxicity; macrophage activation syndrome; muscle weakness; myasthenia gravis; nausea and vomiting; nephritis; peripheral neuropathy; pneumonia; practice guideline; pruritus; psoriasis; pure red cell anemia; quality of life; randomized controlled trial (topic); rash; Review; rosacea; transverse myelitis; treatment outcome; urticaria; visual disorder; clinical trial; immunotherapy; liver cell carcinoma; liver tumor; multicenter study; pathology; practice guideline; procedures; Carcinoma, Hepatocellular; Guidelines as Topic; Humans; Immunotherapy; Liver Neoplasms
Publisher
BMJ Publishing Group
Type
review