Episode # 58 • 05 May 2026
Advanced Hepatocellular Carcinoma: Navigating Second-Line Therapy Options
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.
Timestamps
00:00 - Introduction
01:15 - Second-Line Treatment for HCC: Lenvatinib vs Ramucirumab
04:28 - Tolerability And Sequencing Reality: Cabozentinib
06:35 - Treatment Options for Rapid Progression After Atezolizumab + Bevacizumab
11:40 - Practical Tyrosine Kinase Inhibitor Dosing for HCC
13:44 - Next-Generation Sequencing vs Biopsy In HCC Practice
19:10 - Future Biomarker Clinical Trials: Risks and Impact on Practice
24:31 - Role of Second-Line Immunotherapy in HCC
Resources
You may also like
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.
The Materials available on BackTable are provided for informational and educational purposes only and are not a substitute for the independent professional judgment of a qualified healthcare professional in diagnosing or treating patients. Any opinions, statements, or views expressed are those of the individual contributors and do not necessarily reflect those of the publisher, platform, or any affiliated organization.