Clinical decision-making in advanced hepatocellular carcinoma

ASCO convened an expert panel to update the 2020 guidelines on systemic therapy for advanced hepatocellular carcinoma. The panel updated the systematic review to include 10 new randomized controlled trials published through October 2023. Atezolizumab + bevacizumab or durvalumab + tremelimumab may be proposed as first-line therapy. Where there are contraindications to these treatments, sorafenib, lenvatinib or durvalumab may be proposed as first-line therapy. After first-line treatment, second-line treatment with a tyrosine kinase inhibitor, ramucirumab (for patients with alpha-fetoprotein [AFP] ≥400 ng/mL), durvalumab + tremelimumab or nivolumab + ipilimumab may be recommended. All recommendations are available on the ASCO website.