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Treatment options for patients with hepatocellular cancer (HCC) have recently expanded beyond sorafenib to include first-line therapy with lenvatinib and second-line therapy with regorafenib, nivolumab, or cabozantinib. Also, in the prior REACH trial (Lancet Oncol 2015; 16:859), the VEGFR2-targeting antibody ramucirumab had a potential survival benefit as second-line therapy in the subset of patients with HCC and elevated alpha-fetoprotein (AFP), despite an absence of a survival benefit among all patients.
To evaluate ramucirumab further in this setting, investigators conducted an industry-sponsored, international, randomized, double-blind, placebo-controlled, phase III trial (REACH-2) involving 292 HCC patients with AFP concentrations ≥400 …