OnCo

Hepatoblastoma: lines of therapy

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4 standard-of-care settings across 4 lines and 3 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersFRαRisk group
Early / localised··1
Advanced, first line··1
Second line1··
Third line and beyond·1·

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
Risk groupVery low / standard risk (PRETEXT I-III, resectable, AFP >100)Upfront resection for PRETEXT I-II (COG) or cisplatin monotherapy ×4-6 with delayed resection (SIOPEL-3); sodium thiosulfate after each cisplatin dose for otoprotection.81

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
Risk groupHigh risk (metastatic, AFP <100, PRETEXT IV, vascular involvement)Cisplatin-doxorubicin (PLADO) or dose-dense cisplatin (SIOPEL-4), resection of primary and lung metastases; consider C5VD (COG).81

Second line

SubgroupSettingApproachProducts and trialsEvidence
All comersUnresectable after chemotherapy (POST-TEXT IV, central vascular involvement)Orthotopic liver transplantation (5-year survival ~80%); early referral to a transplant centre.40

Third line and beyond

SubgroupSettingApproachProducts and trialsEvidence
FRαRelapsed/refractoryIrinotecan-based salvage, surgery for isolated recurrence, transplant if liver-confined; trials.47

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.