Are we making any progress at all in the treatment of Advanced - PowerPoint PPT Presentation

Are we making any progress at all in the treatment of Advanced hepatocellular carcinoma? Bert H. O’Neil, MD Cusick Professor of Oncology Director, GI and Phase I Clinical Trials IU Simon Cancer Center

Disclosures Amgen Inc, Bayer HealthCare Advisory Pharmaceuticals, Genentech BioOncology Committee

Introduction • Most HCC is diagnosed at advanced stage ( Most HCC is d M C is d diagn agn agn no osed at advance e (ie ie, e unresectable le/non le on- on n-transplantable) • Therapeutic choices for advanced HCC depend on Therapeutic choices for advance T tumor and liver characteristics

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�� Tumor cell Endothelial cell or Pericyte Autocrine Paracrine EGF/HGF PDGF- β VEGF loop stimulation PDGFR- β VEGFR-2 Apoptosis RAS RAS RAF �� RAF �� Mitochondria MEK Mitochondria MEK Angiogenesis: HIF-2 EGF/HGF ERK Differentiation Apoptosis ERK Proliferation PDGF Migration VEGF Nucleus Tubule formation Nucleus Proliferation Survival ��

�� Sorafenib 400 mg p.o. bid �� (n = 299) ��

�� 1.00 Sorafenib Median: 46.3 weeks (10.7 mo) (95% CI; 40.9 - 57.9) 0.75 Survival Probability Placebo Median: 34.4 weeks (7.9 mo) (95% CI; 29.4 - 39.4) 0.50 0.25 Hazard ratio (S/P): 0.69 (95% CI; 0.55 - 0.87) P < 0.001 0 0 8 16 24 32 40 48 56 64 72 80 W eeks Patients at risk Sorafenib: 299 274 241 205 161 108 67 35 12 0 0 Placebo: 303 276 224 179 126 78 47 25 7 2 0 ��

Years then passed…. Brivanib Sunitinib Erlotinib Everolimus

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Regorafenib 11 Target Oncol. 2015; 10(2): 199–213.

Regorafenib in HCC �� Bruix J et al, ESMO World GI Congress, 2016 Abstract LBA03

REGO Adverse Events �� Bruix J et al, ESMO World GI Congress, 2016 Abstract LBA03

Overall Survival RECIST 1.1 RR 6.6%

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Are we making any progress at all in the treatment of Advanced - PowerPoint PPT Presentation

Are we making any progress at all in the treatment of Advanced hepatocellular carcinoma? Bert H. ONeil, MD Cusick Professor of Oncology Director, GI and Phase I Clinical Trials IU Simon Cancer Center Disclosures Amgen Inc, Bayer

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Are we making any progress at all in the treatment of Advanced - PowerPoint PPT Presentation

Are we making any progress at all in the treatment of Advanced hepatocellular carcinoma? Bert H. ONeil, MD Cusick Professor of Oncology Director, GI and Phase I Clinical Trials IU Simon Cancer Center Disclosures Amgen Inc, Bayer

MALE INFERTILITY CASE-I Before Treatment: After Treatment: After Treatment: CASE 2 BEFORE

Making maps pretty Andrea Aime Jim Groffen Making Maps Pretty Making Maps Pretty 1 1 Making

This is a fact in the treatment of alcohol and drug abuse: Patients who do well in treatment

SOCIAL PROGRESS INDEX SOCIAL SOCIAL PROGRESS PROGRESS IMPERATIVE IMPERATIVE Social Progress

Chiropractic Treatment of the Elite Athlete Chiropractic Treatment of the Elite Athlete

New Developments in Cancer Treatment Dulcinea Quintana, MD Mortality Rates Goals of treatment

Making Every Contact Count (MECC) Content What is Making Every Contact Count? Who is

TUFF TUFF TUFF TUFF TUFF TUFF TUFF TUFF MAKING MAKING MAKING MAKING SENSE OF SENSE OF

Making Mother Happy Making Mother Happy Titus 1:1-3 Titus 1:1-3 Making Mother

Background Paper: Progress on the Background Paper: Progress on the Background Paper: Progress on

HIV, Health &amp; Development 2019 The world is making progress on the The world is making

DECISION MAKING readysetpresent.com Decision Making Program Objectives ( 1 of 2 ) To examine

URBAN WASTEWATER URBAN WASTEWATER URBAN WASTEWATER URBAN WASTEWATER TREATMENT TREATMENT

SEWEGE TREATMENT SYSTEM Sewage treatment system with WC Sewage treatment system without WC

Mendota Juvenile Treatment Center Mendota Juvenile Treatment Center The most violent

LOCHGILPHEAD LOCHGILPHEAD WASTEWATER TREATMENT WASTEWATER TREATMENT FACILITY FACILITY

Outline Hematopoeitic stem cells (HSCs) 1. Mesenchymal Stem Cell-based therapies for diseases

Expresses Condicionais Jos Romildo Malaquias Departamento de Computao Universidade

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Baumgartner, POLI 203 Spring 2016 Botched executions April 20, 2016 Catching Up Prison

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Newsletter

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HIV, Health & Development 2019 The world is making progress on the The world is making