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Systemic Therapy for Hepatocellular Carcinoma Advanced Treatments with Tyrosine Kinase Inhibitors


HCC, which comprises up to 90% of all hepatic malignancies in the United States, is a significant global health burden. The main treatment approach for HCC is surgical resection, but most patients are not eligible due to tumor extent or underlying liver dysfunction. For unresectable intermediate-stage HCC, guideline recommendations advocate the use of loco-regional ablative or transarterial therapies, including embolization (TAE), chemoembolization (TACE), drug-eluting bead-TACE (DEB-TACE), or radioembolization (TARE). There have been a number of advancements in systemic treatment approaches for HCC, including those that utilize protein kinase inhibitors. Sorafenib, lenvatinib, regorafenib, and cabozantinib are TKI options to treat patients with unresectable or advanced HCC. As data continue to emerge with new and emerging agents and various combination strategies, providers who treat patients with HCC will need to integrate them into evidence-based, guideline-directed treatment decisions. How to best sequence these agents and or optimal combinations remains an area of debate requiring collaboration among clinicians and the integration of the most recent, available evidence. As no single treatment will be universally effective due to variations in disease stage and severity, underlying etiology and pathology, and patient characteristics, tailored management plans must be developed that take into account the expertise of the oncology care team, which could include hepatologists, surgeons, interventional radiologists, and community oncologists.

This webcast focuses on the systemic therapy options for HCC with a focus on TKIs.


Ghassan K. Abou-Alfa, MD, MBA
Memorial Sloan Kettering Cancer Center
Cathy Eng, MD, FACP, FASCO
David H. Johnson Endowed Chair in Surgical and Medical Oncology, Co-Director, GI Oncology, Co-Leader, Gastrointestinal Cancer Research Program
Vanderbilt-Ingram Cancer Center, MD Anderson Cancer Center
Laura Goff, MD, MS
Associate Professor of Medicine, Hematology/Oncology; Executive Medical Director for the VICC Cancer Patient Care Center
Vanderbilt-Ingram Cancer Center

David H. Ilson, MD, PhD
Weill Cornell Medical College, Memorial Hospital
Memorial Sloan Kettering Cancer Center
New York, New York
Ahmed O. Kaseb, MD
Professor, GI Medical Oncology
The University of Texas MD Anderson Cancer Center
Pashtoon M. Kasi, MD, MS
Assistant Professor
University of Iowa
Armeen Mahvash, MD
Associate Professor
The University of Texas MD Anderson Cancer Center


Provided by North American Center for Continuing Medical Education, LLC (NACCME), an HMP Company.

For questions regarding this educational activity, please call 609-371-1137 or email


This educational activity is designed to meet the educational needs of those who are involved and/or interested in the treatment of patients with GI cancers, community oncologists, physicians, physician assistants, physicians-in-training, oncology nurses, and pharmacists.


After participating in this activity, learners should be better able to:

  • Describe the mechanisms, efficacy, safety, and indications of TKIs for the treatment of HCC
  • Assess the latest clinical data and rationale surrounding new and emerging TKI-utilizing combination treatment approaches
  • Optimize treatment strategies for unresectable HCC across disease stages with evidence-based therapeutic selection, sequences, and management of adverse events (AEs) 


To be eligible for credit, participants must complete the online activity and the evaluation. Upon completing the activity, there will be instructions on how to complete the evaluation and print a certificate or other documentation of credit.

Release Date: November 29, 2021 
Expiration Date: November 29, 2022 
Estimated Time to Complete: 145 minutes

There is no fee associated with this activity.


Supported by educational grants from: Bayer HealthCare Pharmaceuticals, Inc., Exelixis, Inc., and Merck Sharp & Dohme Corp.



In support of improving patient care, this activity has been planned and implemented by North American Center for Continuing Medical Education (NACCME) and Imedex. NACCME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


NACCME designates this internet enduring activity for a maximum of 2.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


American Academy of Nurse Practitioners National Certification Program accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.


This continuing nursing education internet enduring activity awards 2.75 contact hours.

Provider approved by the California Board of Registered Nursing, Provider #13255 for 2.75 contact hours. 


This internet enduring, knowledge-based activity (Universal Activity Number: JA0006201-0000-21-205-H01-P) has been approved for a maximum of 2.75 contact hours (0.275 CEUs).

The certificate is not the official record of your participation in the activity. The official record of credit will be the information in the CPE Monitor system. Following ACPE Policy, NACCME must transmit your claim to CPE Monitor within 60 days from the date you complete this CPE activity. NACCME is not able to report your claimed credit after this 60-day period. Eligibility for pharmacy credit is contingent upon the successful completion of a post-test and/or evaluation for each activity or session attended.


NACCME has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with the AAPA CME Criteria. This internet enduring activity is designated for 2.75 AAPA Category 1 credits. PAs should only claim credit commensurate with the extent of their participation.


This continuing medical education activity may include device or medicine brand names for participant clarity purposes only, due to the presence of different branded versions of the same product. No product promotion or recommendation should be inferred.


This activity may contain information about experimental and other uses of drugs or devices that are not currently approved by the European Medicines Agency (EMA) of the European Union or the Food and Drug Administration (FDA) of the United States. Participants are strongly encouraged to consult approved product labeling for any drug or device mentioned in this activity before use. The opinions expressed during this activity are the opinions of the respective authors, presenters or moderators and do not necessarily reflect the opinions of NACCME.


The material presented and related discussions are not intended to be medical advice, and the presentation or discussion of such material is not intended to create and does not establish a physician-patient relationship. Medical advice of any nature should be sought from an individual’s own physician.

Neither NACCME nor any of its subsidiaries or affiliates is affiliated with, or formally endorsed by a medical society.

The opinions expressed in this educational activity are those of the faculty and are not attributable to NACCME or HMP. Clinical judgment must guide each professional in weighing the benefits of treatment against the risk of toxicity. Dosages, indications, and methods of use for products referred to in this activity are not necessarily the same as indicated in the package insert for each product, may reflect the clinical experience of the presenters, and may be derived from the professional literature or other clinical sources. Consult complete prescribing information before administering.


NACCME, LLC is an independent provider(s) of continuing medical education. NACCME, LLC has no proprietary or financial interest in medical or healthcare products over which the FDA (USA) or EMA (EU) has regulatory authority.

NACCME, LLC assures that all educational materials are reviewed to ensure for the absence of commercial bias, fair balance, scientific objectivity, and levels of evidence. The educational activity will not be influenced by commercial organizations and will not conflict with any other scheduled educational activities.

According to the disclosure policy of NACCME, faculty, editors, managers, and other individuals who are in a position to control content are required to disclose any relevant financial relationships with relevant commercial companies related to this activity. All relevant conflicts of interest that are identified are reviewed for potential conflicts of interest. If a conflict is identified, it is the responsibility of NACCME to initiate a mechanism to resolve the conflict. The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation.


The faculty has reported the following:

Ghassan K. Abou-Alfa: Advisory Board-Agios, Alnylam, AstraZeneca, Autem, Beigene, Eisai, Exelixis, GenoScience Pharma, Helio, Vector; Consultant-Agios, Alnylam, AstraZeneca, Autem, Bayer, Beigene, Berry Genomics, Celgene, CytomX, Eisai, Eli Lilly, Exelixis, Flatiron, Genentech/Roche, GenoScience Pharma, Helio, Incyte, Ipsen, Legend Biotech, Loxo, Merck, MINA, QED Therapeutics, Rafael, Redhill, Silenseed, Sillajen, Sobi, Surface Oncology, Therabionics, Twoxar, Vector, Yiviva; Grant/Research Support-Agios, Arcus, AstraZeneca, Berry Genomics, BioNtech, Bristol Myers Squibb, Celgene, Flatiron, Genentech/Roche, GenoScience Pharma, Incyte, Polaris, Puma, QED Therapeutics, Sillajen, Yiviva

Cathy Eng: Advisory Board Gilead, Halio DX, NateraConsultant - GlaxoSmithKline, Merck

Laura Goff: Advisory Board/Consultant - Lilly, Eisai, Bayer/Onyx, Newlink Genetics, QED, AstraZeneca, Incyte, Genentech, Merck; Grant/Research Support - Astellas Pharma, Pfizer, Onyx, Sun Pharma, Lilly, Bristol-Myers Squibb, Agios, ArQule, H3 Biomedicine, Incyte, Leap Therapeutics, ASLAN Pharmaceuticals, BeiGeneBasilea
David H. Ilson: Advisory Board-Amgen; Consultant-Astellas, Bayer, BMS, Eli-Lilly, Lilly, Merck, Roche/Genentech, Taiho Pharmaceutical

Ahmed O. Kaseb: Advisory Board - BAYER, Bristol Myers Squibb, Eisai Inc, Exelixis, Genentech F. Hoffman-La Roche Ltd, Merck & Co., Inc.; Consultant - BAYER, Bristol Myers Squibb, Eisai Inc, Exelixis, Genentech F. Hoffman-La Roche Ltd, Merck & Co., Inc. Grant/Research Support - Abivax, Adaptimmune, BAYER, Bristol Myers Squibb, Eisai Inc, Exelixis, Genentech F. Hoffman-La Roche Ltd, Henguri, Merck & Co., Inc.

Pashtoon M. Kasi: Advisory Board, Consultant-AstraZeneca, Foundation Medicine, Merck MSD, Natera

Armeen Mahvash: Advisory Board - ABK Biomedical, SIRTEX Medical ltd; Consultant - ABK Biomedical, SIRTEX Medical ltd; Grant/Research Support - ABK Biomedical, Boston Scientific Corporation, SIRTEX Medical ltd

Planning Committee

In addition to the faculty listed above, NACCME and Imedex planners and staff include Samantha Conforti, Kelly Jackson, Mary Johnson, Amanda Mulder, Paul O'Neil, Randy Robbin, Manjusha Sala, and Greaton Sellers.

No NACCME or Imedex planner or staff has disclosed any relevant financial relationship with any ineligible company (commercial interest).


North American Center for Continuing Medical Education (NACCME) complies with the legal requirements of the Americans with Disabilities Act and the rules and regulations thereof. If any participant in this educational activity is in need of accommodations, please call 609-371-1137.


NACCME protects the privacy of personal and other information regarding participants, educational partners, and joint providers. NACCME and our joint providers will not release personally identifiable information to a third party without the individual’s consent, except such information as is required for reporting purposes to the appropriate accrediting agency. NACCME maintains physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

Copyright © 2021 by North American Center for Continuing Medical Education, LLC. All rights reserved. No part of this accredited continuing education activity may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from North American Center for Continuing Medical Education.


Any participant wanting to file a grievance with respect to any aspect of a continuing education activity accredited by NACCME, LLC may contact Samantha Conforti, Manager, Accreditation and Compliance, by phone at 609-371-1137, by email at or in writing at 104 Windsor Center Drive, East Windsor, NJ 08520. Ms. Conforti will review the grievance and respond within 30 days of receiving the complaint. If the participant is unsatisfied with the response, an appeal to the Associate Director, Greaton Sellers, Accreditation and Compliance, can be requested for a second level of review. Mr. Sellers can be contacted via email at