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Design and created by Guideline Central in participation with the American Society of Clinical Oncology.

Systemic Therapy for Advanced Hepatocellular Carcinoma

Patient Guideline

American Society of Clinical Oncology

Publication Date:

Systemic Therapy Options for Advanced Hepatocellular Carcinoma.

Name	Type	Taken As	Treatment sequence^a
atezolizumab & bevacizumab	Immunotherapy & Targeted Therapy	IV	1^st preferred OR 2^nd
durvalumab & tremelimumab	Immunotherapy	IV	1^st preferred OR 2^nd
sorafenib	Targeted Therapy (TKI)	Oral	1^st alternate OR 2^nd
lenvatinib	Targeted Therapy (TKI)	Oral	1^st alternate OR 2^nd
durvalumab	Immunotherapy	IV	1^st alternate OR 2^nd
nivolumab & ipilimumab	Immunotherapy	IV	2^nd
nivolumab	Immunotherapy	IV	2^nd
pembrolizumab	Immunotherapy	IV	2^nd
ramucirumab	Targeted Therapy (patients with AFP ≥400 ng/mL)	IV	2^nd
cabozantinib	Targeted Therapy (TKI)	Oral	2^nd
regorafenib	Targeted Therapy (TKI)	Oral	2^nd

^a For patients who have good liver function, and the ability to do daily activities, third-line treatment with any of the medications listed in this table may be recommended, as long as these medications work differently from any other medications that have already been tried.

Abbreviations: IV, intravenous; TKI, tyrosine kinase inhibitor.

Source Citation

John D. Gordan, MD, PhD; Erin B. Kennedy, MHSc; Ghassan K. Abou-Alfa, MD, MBA, et al. Systemic Therapy for Advanced Hepatocellular Carcinoma: ASCO Guideline. J Clin Oncol. 2024 March 19. doi: JCO.23.02745