Ep. 58 Advanced Hepatocellular Carcinoma: Navigating Second-Line Therapy Options with Dr. A. Craig Lockhart and Dr. Lingling Du

When first-line treatment for advanced hepatocellular carcinoma (HCC) fails and the disease progresses, what options are available for second-line therapy? In this episode of the BackTable 2026 HCC Creator Weekend™, Drs. Lingling Du, A. Craig Lockhart, and Jon Mizrahi explore the uncertain landscape of second-line treatment after first-line immunotherapy, such as atezolizumab and bevacizumab or the STRIDE regimen, including practical considerations for choosing which second-line therapy to use. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:15 - Second-Line Treatment for HCC: Lenvatinib vs Ramucirumab04:28 - Tolerability And Sequencing Reality: Cabozentinib06:35 - Treatment Options for Rapid Progression After Atezolizumab + Bevacizumab11:40 - Practical Tyrosine Kinase Inhibitor Dosing for HCC13:44 - Next-Generation Sequencing vs Biopsy In HCC Practice19:10 - Future Biomarker Clinical Trials: Risks and Impact on Practice24:31 - Role of Second-Line Immunotherapy in HCC --- More about this episode The doctors discuss real-world dosing strategies for tyrosine kinase inhibitors (TKI), management of rapid progression, and the limited utility of next-generation sequencing and biopsy in HCC. They also highlight ongoing biomarker clinical trials and the evolving role of second-line immunotherapy. They note that few patients reach third-line therapy due to declining performance status and liver function, as well as mixed results from adding CTLA-4 inhibitors after disease progression. --- Resources HIMALAYA Clinical Trialhttps://www.annalsofoncology.org/article/S0923-7534(24)00049-8/fulltext --- BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app