Al B. Benson, MD, FACP, FASCO, professor of medicine and director for Cooperative Groups at the Robert H. Lurie Comprehensive Cancer Center, discusses the potential for neoadjuvant intervention in hepatobiliary cancers.
Al B. Benson, MD, FACP, FASCO, professor of medicine in the Division of Hematology and Oncology at Northwestern University Feinberg School of Medicine and director for Cooperative Groups at the Robert H. Lurie Comprehensive Cancer Center, discusses the potential for neoadjuvant intervention in hepatobiliary cancers in light of recent National Comprehensive Cancer Network guideline updates. Benson serves as chair of the panel.
The guidelines call for avoiding unnecessary surgery, emphasizing opportunities to utilize neoadjuvant treatment options or enroll patients in clinical trials. Can you discuss this approach?
There are patients who may be high risk, and the concern is they may rapidly progress—for example, in the case of a patient with gallbladder cancer. There is interest in exploring perhaps neoadjuvant approaches for those individuals and interest in looking, for example, at chemotherapy prior to surgical consideration. So, I think the emphasis here is that these individuals really require a multidisciplinary approach. There are individuals who may be candidates for example, for initial liver directed therapies or chemotherapy combinations. There is interest looking at combinations of liver-directed therapies and immunotherapy. There's clearly an interest in these, what you might call borderline patients to look at initial therapy prior to surgical consideration.