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Related Concept Videos

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Related Experiment Video

Updated: Jun 30, 2025

An Oncogenic Hepatocyte-Induced Orthotopic Mouse Model of Hepatocellular Cancer Arising in the Setting of Hepatic Inflammation and Fibrosis
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Systemic Therapy for Advanced Hepatocellular Carcinoma: ASCO Guideline Update.

John D Gordan1, Erin B Kennedy2, Ghassan K Abou-Alfa3,4

  • 1University of California, San Francisco, San Francisco, CA.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
|March 19, 2024
PubMed
Summary

New guidelines recommend atezolizumab plus bevacizumab or durvalumab plus tremelimumab as first-line treatments for advanced hepatocellular carcinoma (HCC). These options are for patients with Child-Pugh class A liver disease and good performance status.

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Area of Science:

  • Hepatobiliary Oncology
  • Gastrointestinal Medical Oncology
  • Clinical Practice Guidelines

Background:

  • Advanced hepatocellular carcinoma (HCC) presents significant treatment challenges.
  • Current treatment strategies require regular updates based on emerging evidence.

Purpose of the Study:

  • To provide updated, evidence-based clinical recommendations for the systemic therapy of advanced HCC.
  • To assist healthcare professionals in making informed treatment decisions for HCC patients.

Main Methods:

  • An Expert Panel convened to update the 2020 ASCO guideline for HCC.
  • A systematic review of randomized controlled trials (RCTs) published up to October 2023 was conducted.
  • Recommendations were updated based on the latest evidence.

Main Results:

  • Ten new RCTs were incorporated into the evidence base.
  • Atezolizumab plus bevacizumab (atezo + bev) and durvalumab plus tremelimumab (durva + treme) are recommended first-line options for eligible advanced HCC patients (Child-Pugh A, ECOG 0-1).
  • Alternative first-line therapies include sorafenib, lenvatinib, or durvalumab if contraindications exist.

Conclusions:

  • The updated guideline provides a sequential treatment approach for advanced HCC, including first-, second-, and third-line systemic therapies.
  • Specific recommendations are provided for various treatment lines, considering patient performance status and liver function (Child-Pugh A vs. B).
  • A cautious approach to systemic therapy is advised for patients with Child-Pugh class B advanced HCC.