What is your treatment approach for a patient with metastatic hepatocellular carcinoma with Child's Pugh B cirrhosis?
Do you use specific Child Pugh score cutoff for incorporating doublets (atezo/bev or durva/treme) for 1st line treatment of advanced HCC?
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Child Pugh B cirrhosis is a spectrum of disease, and requires careful consideration of the underlying cause of the cirrhosis as well as the potential impact of cancer therapy. As @Dr. First Last pointed out, there is data for sorafenib in this patient population, demonstrating a similar relative ben...
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I agree with the above comments. The data is, unfortunately, limited for some of the novel agents we have in first line including IMbrave150 and HIMALAYA for Child Pugh B or higher.
Having said that, clinically, if a patient has CP of 7 and is functionally well, I do not hesitate to consider atezoliz...
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Data driven treatment of patients with advanced HCC and Child Pugh B cirrhosis are limited to first line sorafenib (Miller et al., PMID 19255312) and nivolumab (Kambhampati et al., PMID 31154669). Child Pugh is an exponential spectrum, and early Child Pugh B deserves a serious look. Child-Pugh consi...
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More data is needed for sure. Sorafenib or single agent nivolumab can be considered based on data with these agents in Child-Pugh B7, 8 patients.
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