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The new standard of care to treat advanced hepatocellular cancer is the combination of atezolizumab and bevacizumab. Recent studies also support first-line use of the combination of tremelimumab and durvalumab. Both of these regimens achieved superior survival compared to sorafenib. Cabozantinib, an approved agent for second- or later-line treatment of advanced hepatocellular cancer, is now being studied as an earlier-line therapy.
In an industry-sponsored, open-label, randomized, phase 3 trial researchers compared first-line use of the combination of atezolizumab and cabozantinib to sorafenib alone, and cabozantinib alone to sorafenib alone. Patients were randomized 2:1:1 to receive cabozantinib (40 mg orally daily) plus atezolizumab (1200 …