Per the trial, this was required within 6 months of starting the study. However, in practice, I don't know that this strict rule would be necessary. For example, what if an EGD was done 10 months ago without varices? I don't think I would feel strongly about this. Similarly, if we could get one shor...

Yes, our practice is to perform EGD prior to initiation of atezolizumab/bevacizumab, mirroring the IMbrave150 protocol. Thus far, I have not recommended against proceeding with this regimen based on endoscopic results. However, I have had a number of patients for which variceal banding was performed...

I would probably refer for EGD if not done in the last 3-6 months. Potentially, if there is no clinical deterioration since a normal EGD in the past year, I might consider the initiation of therapy and concurrent referral for EGD.

I do refer all patients for EGD prior to initiation of atezolizumab/bevacizumab given the risk of bleeding with bevacizumab in HCC patients and given the fact that the IMBrave150 phase 3 study mandated EGD on all patients. As we get more data from the IMBrave study about the EGD results and types o...