How do you manage patients on atezolizumab/bevacizumab with advanced HCC who develop arterial thrombosis?

Arterial thrombosis such as coronary artery events or CVAs is an indication to discontinue bevacizumab. Patients with arterial thrombotic events within the past 6 months should not be treated with bevacizumab; events older than 6 months do not represent a contraindication, especially if the patient ...

I would stop bevacizumab if there is arterial thrombosis and start anticoagulation, continue single-agent atezolizumab. Would not stop the bevacizumab for portal vein thrombosis as it is most of the time a tumor thrombus.

Arterial, I think, would require us to stop the bevacizumab. Portal vein thrombus is common with HCC and it would not concern me. Arterial clots are more serious. I would continue atezolizumab alone.

I would stop bevacizumab and initiate anticoagulation. I would continue single-agent atezolizumab.

Since HCC patients are already prone to developing bland thrombosis, this is not a contraindication to start therapy in patients with existing bland thrombosis and clinical discretion will guide anticoagulation therapy. However, if patients develop bland thrombosis while on therapy, most likely this...

Start anticoagulation.