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For patients with advanced inoperable hepatocellular carcinoma (HCC), new therapeutic options beyond sorafenib have been approved. However, the optimal initial therapy remains to be established.
To compare treatment in this setting with sorafenib versus liver-directed radioembolization with yttrium-90 resin microspheres, investigators in Asia conducted an industry-sponsored, international, open-label, randomized phase III trial involving patients with liver-confined HCC. Of 360 randomized patients, 162 received sorafenib, but only 130 received intrahepatic radiation due to technical ineligibility to undergo the procedure. Most patients had performance status 0 (51%–55%), Child-Pugh A liver disease (90%–91%), and hepatitis B etiology (51%–58%…