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CME: Pharmacotherapy for Hepatocellular Carcinoma (HCC): Therapeutic Updates, Best Practices, and Emerging Therapies

Activity Description / Statement of Need:

In this online, self-learning activity:

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer related deaths and one of the more common types of cancer affecting the population worldwide. It is an aggressive form of liver cancer occurring with increasing incidence and in 78% of cases worldwide is caused by hepatitis B and hepatitis C virus infections. HCC is often fatal as it is primarily diagnosed in the advanced disease state and carries a grim prognosis: 5-year survival rates are typically no more than ten percent. Though the etiology itself can be complex, improvements in screening and treatments may help to reduce the burden of HCC in the population worldwide.

It has also been determined that by doing surveillance in high risk individuals, HCC can be caught much earlier and therefore have a more positive prognosis potentially leading to increased rates of survival. Screening guidelines for HCC released by the American Association for the Study of Liver Diseases (AASLD) include recommendations by ethnicity, exposures, disease states, and family history.  Updated information is also available regarding serologic markers used in the screening process. As the incidence of HCC increases, there will be a greater need to increase surveillance and screening of it in at risk populations. By diagnosing HCC earlier, more curative treatment options are available and the prognosis improves.

Target Audience:

The following healthcare professionals: medical oncologists, hepatologists, interventional radiologists, endocrinologists; physician assistants, nurse practitioners, nurses, and pharmacists who practice in oncology; and any other healthcare professionals with an interest in or who clinically encounter patients with HCC, and. patients and/or their caregivers may also derive benefit from participating in the learning activity.

Commercial Support Disclosure: This program is supported by educational grants from Eisai.

Release Date: February 19, 2019 -- Expiration Date: February 19, 2021

Faculty: Laleh Melstrom, MD


Faculty introduction, disclosures

Introduction content: cursory refresher and review

  • Epidemiology: statistics, and demographics
  • Causes and risk factors, modifiable and non-: age, genetics, comorbid diseases, and alcohol intake
  • Pathogenesis
  • Updates in diagnosis and staging: labs, biopsy. and imaging

Treatment of HCC

  • Goals of therapy
  • Surgical resection and nonpharmacotherapy treatments
  • Systemic therapy
  • Molecularly targeted therapy: sorafenib, cabozantinib, regorafenib, lenvatinib
  • Immunotherapy: nivolumab
  • Radiation therapy and stereotactic body radiotherapy; radioembolization with yttrium-90 [90Y] resin microspheres or iodine-131 [131I]- labeled lipiodol
  • Safety profiles of present and emerging agents
  • Challenges and barriers to care
  • Patient case(s)

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Apply existing guideline recommendations in the diagnosis of HCC
  • Identify present and emerging pharmacotherapeutic treatments for management of unresectable HCC and apply them to patient cases using evidence-based medicine.
  • Describe how to manage challenges that arise during treatment with present and emerging pharmacotherapeutic treatments for HCC, including adverse effect management, and apply that knowledge to a patient case
  • Describe the challenges associated with treating patients with HCC, focusing specifically on the risks (e.g., adverse drug reactions, drug interactions, et cetera) of the agents used to treat the disease, and apply that information in optimizing patient care in a patient case


This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of  1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Physicians: For applicable courses, to attain maintenance of certification (MOC) credit, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC credit for this activity. Please note: not all activities on this site provide MOC credit. If this activity does not specify that it provides MOC credit in the "Accreditation" section on this page, then it does NOT provide MOC credit.


ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmaceutical education. This program is approved for 1.0 hours (0.1 CEUs) of continuing education.  Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test.   Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit.  ACPE # 0574-0000-19-002-H01-P.  ACPE Accreditation effective 2/24/2019, expires 2/24/2021. This is a Knowledge (K)-type activity.

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.  ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.


Faculty Disclosure: Leah Melstrom, MD has no relevent financial discloses.


Disclosures of Educational Planners: Charles Turck, PharmD has no relevent financial discloses.


Commercial Support Disclosure: This program is supported by educational grants from Eisai


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

Additional Courses That Are Related To This Activity

Renal Cell Carcinoma (RCC): Optimizing Pharmacotherapeutic and Interventional Management Strategies

Advanced Prostate Cancer (aPC): Therapeutic Updates, Best Practices, and Emerging Treatments

Advances in Treating Metastatic Colorectal Cancer (CRC): Optimizing Recognition and Pharmacotherapeutic Management Strategies

Advanced prostate cancer: Optimizing management strategies