Patients with advanced hepatocellular carcinoma (aHCC) and Child-Pugh B (CPB) cirrhosis have a poor prognosis and are often excluded from clinical trials.¹ The overall survival (OS) of sorafenib-treated patients with CPB and aHCC is approximately 4 months.¹ Based on the CheckMate 040 trial, which was an open-label, multicohort and phase 1/2 study, nivolumab received accelerated approval in the United States for sorafenib-treated patients with aHCC.¹ At a median follow-up of 16.3 months, the investigator-assessed objective response rate (ORR) and median OS were 12% and 7.6 months in CPB (cohort 5) patients, respectively.¹ The National Comprehensive Cancer Network (NCCN) guidelines thus recommended nivolumab as a treatment option for certain CPB and aHCC patients.¹ The long-term efficacy, safety and biomarker analyses for this CPB cohort were presented, which was probably the first prospective immunotherapy trial in this population.

The global incidence of Hepatocellular carcinoma (HCC) has been rising.¹ In the meantime, treatment with atezolizumab (ATEZO) plus bevacizumab (BEV) has gained approval in more than 70 countries for unresectable HCC patients who have not received prior systemic therapies.² Evidence has shown that the combination of ATEZO and BEV significantly improved the overall survival (OS) and the progression-free survival (PFS).³ From the previous primary analysis of IMbrave150, ATEZO plus BEV successfully prolonged the survival safely in unresectable HCC.⁴ The recent update of IMbrave150 reported on the efficacy and safety of ATEZO plus BEV in patients with prior locoregional therapies (LRTs).