Are you comfortable using durvalumab + tremelimumab in advanced HCC with portal vein thrombus, when these patients were not included in the HIMALAYA trial?

Main portal vein thrombus (Vp4) has consistently been associated with poor prognosis, and prevalence can range from 20-44% in HCC within 1-3 years of diagnosis (Abdelhamed et al., PMID 39957750). Prior to 2020 and the advent of immunotherapy in the first line, median OS is around 2-5 months. In many...