Consensus on standardized later-line systemic therapy for hepatocellular carcinoma

With rapid advances in systemic therapy for hepatocellular carcinoma (HCC), developing evidence-based treatment strategies after first-line therapy failure has become a major clinical challenge. In this context, establishing a standardized consensus for later-line therapy tailored to clinical practice, acknowledging country-level heterogeneity in drug access and treatment patterns, is of significant clinical importance. Grounded in best available evidence and multidisciplinary expert experience, this consensus addresses key issues after failure of targeted therapy, immune checkpoint inhibitors, or combination regimens, including assessment of disease progression, evaluation of resistance, and optimal timing of treatment switching. It proposes unified evaluation criteria and stratified treatment recommendations. Emphasizing evidence-based, individualized decision-making, the consensus balances efficacy with safety. It aims to promote standardized and more consistent later-line decision-making, providing practice-oriented clinical guidance to improve long-term survival and quality of life for patients with advanced HCC. These recommendations integrate regional real-world experience with available evidence and are contextualized in reference to current international guidelines.