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First-line treatment for patients with unresectable hepatocellular cancer (HCC) is either combination immunotherapy with bevacizumab and atezolizumab or tremelimumab and durvalumab. Although immunotherapy-based combination therapy has replaced tyrosine kinase inhibitors (TKIs) as initial therapy, randomized trials have not indicated superiority of single agent anti–PD-1 or PD-L1 therapy over TKIs.
Investigators have now conducted an industry-sponsored, global, open-label, randomized, phase 3 trial (RATIONALE-301) to compare first-line treatment with the anti–PD-1 agent tislelizumab versus the TKI sorafenib in 674 patients with Child-Pugh class A unresectable HCC. Of the patients, 85% were men, 58% had distant metastases, 76% had received pri…