The Future of HCC Management: An Interview With Dr. David Liu
In this interview, Dr. David Liu discusses HCC management, advanced dosimetry, and the future of IO.
In this interview, Dr. David Liu discusses HCC management, advanced dosimetry, and the future of IO.
Transcript
In this interview, Dr. David Liu, MD at University of British Columbia, Vancouver General Hospital, discusses HCC management, advanced dosimetry, and the future of IO. Read the full transcript below:
IO Learning:
What should IO professionals recognize about liver metastatic disease from this year and moving forward?
David Liu:
I think that the narrative that's really been developed over the last 15 years isn't necessarily about technology, but it's actually about the fact that we do better together than we do alone. That the concept of a single person knowing everything that's out there with regards to the treatments, the options, and the order of therapy is non-existent, and this has really become a team sport.
Conferences like CIO are really critical to this narrative because it provides an opportunity for us to have cross-specialty knowledge translation, and from that, bring these concepts back home to our hospitals and institutions and really translate what I consider to be the cutting edge of therapy in our local environments.
IO Learning:
Can you share some of the advancements or takeaways from advanced dosimetry in 2023 and beyond?
David Liu:
Advancing dosimetry is really advancing the concept of radioembolization. We now understand that we can give too much and we can give too little, but we can also give varying amounts in between to perform procedures that are equivalent to surgical resection, like radiation lobectomy.
We now understand that radiation has the power to trigger the body's immune system and complement the next generation of systemic therapeutics, like the immuno-oncology agents, the CTLA-4s, the PD-1 and PD-1 receptor ligand inhibitors. And, this is really exciting because it's now not just about filling a blood vessel up with stuff, it's actually about understanding the very basic mechanisms of therapy and optimizing them for the next generation of sequence treatments.
IO Learning:
What are some of the most important discussion points in regard to the management of HCC and portal vein thrombosis?
David Liu:
Traditionally, we've always thought of portal vein thrombosis as a death nail for a patient, that it represents a very aggressive condition that we have very little option for. I think the power of radioembolization has really been amplified and resonated over the last few years in the published literature. And not only can we be able to provide an improvement in quality of life, but very clear survival benefit.
Further to that, we can actually bring patients back into earlier stage of disease, literally down staging them to the point where curative options like surgery, as well as radiation ablation or percutaneous ablation can be performed, giving these patients not only a longer life and a better quality of life, but also the possibility of actually having intervals of disease-free presentation.
IO Learning:
What do you foresee, whether it's innovations, networks, or growth, for the future of interventional oncology?
David Liu:
I think one of the biggest challenges in interventional oncology is that we are constantly on the pulse of innovation and technological breakthroughs, and as a result of that, we are oftentimes years ahead of our clinical colleagues in terms of understanding of the context and the impact of what treatments we provide.
Conferences like CIO really provide us an opportunity to sit down with our specialist colleagues, the medical oncologist, the surgical oncologist, the radiation oncologist, to understand where their minds are and be able to better understand how to introduce our treatments in the context of their treatments.
