How long would you continue atezolizumab/bevacizumab in a patient with HCC who is having a prolonged response with stable disease?

Similar to how this was done in the phase 3 trial of atezolizumab/bevacizumab (vs sorafenib), I continue until progression or intolerance. Finn et al., PMID 32402160

This is a perfectly reasonable approach that @Dr. First Last outlined. However, I'm not sure that there is any specific reason to privilege the approach from this study above any other approach (such as discontinuation of immunotherapy after two years of therapy, as is commonly done in other disease settings). The overall survival analysis for the manuscript referenced above ends at 17 months. I would favor some kind of de-escalation of therapy for the modest proportion of patients who remain progression-free after 24 months of combination immunotherapy.

Continue until progression, until toxicity, or the patient asks to stop.

I agree with @Dr. First Last. With stable disease, treatment should continue until progression or intolerance. For those patients with a complete response (5-10%), there has been some data to suggest that stopping therapy is possible; however, recurrence can range from 14-40% (Lim et al., PMID 39998829; Chen et al., ASCO 2025).