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The new standard first-line treatment for advanced hepatocellular cancer is bevacizumab and atezolizumab, replacing prior initial use of sorafenib or lenvatinib. Alternative immunotherapy combinations are under investigation given the potential restricted use of bevacizumab in patients with esophageal varices and portal hypertension.
In an industry-sponsored, global, open-label, phase 3 trial, patients with advanced Child-Pugh class A hepatocellular cancer were randomized to one of three treatments: sorafenib, the anti-PDL-1 agent durvalumab, or the combination of a single dose of the anti-CTLA-4 agent tremelimumab followed by durvalumab. The primary endpoint was overall survival (OS) in the tremelimumab/durvalumab arm versus the sorafenib a…