Loading
Trials recruiting now, the landmark trials, the key papers and what they mean, the latest literature, and the milestones year by year.
Country and place are remembered in this browser only. A postcode is sent to OpenStreetMap's Nominatim service to find coordinates when you press the button; nothing else leaves your device.
The BCLC stages used on this site's hepatocellular carcinoma pages and their default treatments follow this update.
Durvalumab-tremelimumab is a first-line standard for advanced hepatocellular carcinoma, particularly for patients with varices or bleeding risk in whom atezolizumab-bevacizumab is unsuitable.
Patients with advanced liver cancer and good liver function should be offered atezolizumab plus bevacizumab (or durvalumab plus tremelimumab) rather than sorafenib as first treatment; median survival is now around 19 months and about a quarter of patients respond. Endoscopy to treat varices before starting bevacizumab is essential because of bleeding risk. Patients with poorer liver function (Child-Pugh B) or autoimmune disease or transplants were not studied.
Lenvatinib is a first-line alternative to sorafenib and the preferred kinase inhibitor when immunotherapy is contraindicated, such as after liver transplantation.
Sorafenib became the reference standard against which lenvatinib, atezolizumab-bevacizumab and durvalumab-tremelimumab were tested, and remains an option where immunotherapy is unsuitable.
Query for this cancer: (TITLE:"Advanced hepatocellular carcinoma" OR ABSTRACT:"Advanced hepatocellular carcinoma" OR TITLE:"BCLC C" OR ABSTRACT:"BCLC C" OR TITLE:"Advanced-stage HCC" OR ABSTRACT:"Advanced-stage HCC" OR TITLE:"Unresectable hepatocellular carcinoma" OR ABSTRACT:"Unresectable hepatocellular carcinoma" OR TITLE:"Metastatic hepatocellular carcinoma" OR ABSTRACT:"Metastatic hepatocellular carcinoma" OR TITLE:"HCC with portal vein invasion" OR ABSTRACT:"HCC with portal vein invasion") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Advanced hepatocellular carcinoma (BCLC C), not a curated reading list.