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CME: Treatment strategies for hepatocellular carcinoma (HCC): Now, it’s personal(ized)

Activity Description / Statement of Need:

In this online, self-learning activity:

Cancer of the liver is one of the leading causes of cancer-related deaths and one of the more common types of cancer worldwide, with an incidence of over 40,000 in the U.S. and an annual mortality rate of over 30,000 new cases each year. Of all the primary liver cancers, hepatocellular carcinoma (HCC) is the most common form, representing 80%, and its incidence has risen threefold in the U.S. over the past 40 years. The largest risk factor is cirrhosis due to chronic hepatitis B or C viruses, and additional risk factors include excess alcohol consumption, diabetes, non-alcoholic fatty liver disease, and smoking. HCC is diagnosed in the intermediate or advanced stages of disease the vast majority of the time and carries a grave prognosis with a five-year survival rate of eighteen percent.

This learning activity has been designed to bring HCPs’ knowledge of optimal, personalized strategies for the management of advanced / unresectable HCC and to improve their competence and performance in treating it.

Target Audience:

The following healthcare professionals: Medical oncologists, hepatologists, 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 advanced / unresectable HCC.

Commercial Support Disclosure: This program is supported by an educational grant from Exelixis.

This activity is free of charge.

Release Date: December 16, 2021 -- Expiration Date: December 16, 2022

Faculty: Josep Llovet, MD


Faculty introduction, disclosures

Introductory content: defining the context and challenge of advanced / unresectable HCC

  • Epidemiology
  • Prognosis
  • Histopathology and biomarkers

Treatment of unresectable / advanced HCC

  • Goals of therapy
  • Locoregional, unresectable disease options: transarterial chemoembolization (TACE), radioembolization, or systemic therapy
  • Advanced disease

· Child-Turcotte-Pugh class C cirrhosis or extensive comorbidity: Supportive care

· Systemic therapy: Present and investigational agents; lines of therapy; efficacy; safety/toxicity and adverse event mitigation; monitoring

· VEGF and FGFR inhibition

· Checkpoint inhibitor immunotherapy

· Tyrosine kinase inhibition

· Cytotoxic chemotherapy

  • 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:

  • Recall the roles of biomarkers and related testing in personalizing the care plan for patients with unresectable / advanced HCC.
  • Summarize the efficacy of existing and anticipated roles of late-stage investigational management strategies in unresectable / advanced HCC treatment algorithms.
  • Identify the most clinically relevant adverse events associated with present and emerging unresectable / advanced HCC treatments and recommendations for managing them.
  • Formulate a treatment plan for a patient with unresectable / advanced HCC.


ACCME Activity #201805004

This activity has been planned and implemented in accordance with the accreditation requirements 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 1.00 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.


ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

PhysiciansFor 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 this section, then it does NOT provide MOC credit.


ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.00 contact hours (0.1 CEUs) of continuing pharmacy education credit. 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 #0574-0000-21-051-H01-P. This is an Application (A)-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:

Josep M. Llovet, MD, PhD, FAASLD, Professor of Medicine & Director, Liver Cancer Program. Icahn School of Medicine at Mount Sinai, has received financial compensation for research and/or consulting from: Bayer, Eisai, BMS, Boheringer-Ingelheim, Ipsen, Lilly, Celsion, Exelixis, Merck, Genentech, Roche, Glyotest, Nucleix, Sirtex, Min Alpha, and AstraZeneca.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty will not discuss off-label uses.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Exelixis.


  • 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.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • 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.

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