What non-variceal EGD findings, if any, deter you from using atezo/bev in patients with advanced HCC?

I would discuss the severity and risk of bleeding with the endoscopy team and start beta blockers as indicated before starting anti-angiogenesis therapy.

Additional non-variceal EGD findings would deter me from using atezo/bev in patients with advanced HCC. These include the presence of active or recent gastrointestinal bleeding (e.g. from ulcers or erosions of the upper GI tracts), severe gastroduodenal ulceration (even in the absence of bleeding) o...

The recommendation for updating an EGD prior to the use of Atezo/Bev comes specifically from the IMbrave150 drug trial experience, where 7% of the patients in the Atezo/Bev group had an upper GI bleed (UGIB), compared to only 4.5% in the sorafenib group.

It's worth pointing out that one of the exclus...

Given the severity of the presence of the esophageal varices with or without bleeding, my efforts in trying to stop them from bleeding or prevent them from bleeding are most important. I tend to use banding as I go in such cases, with or without injection therapy, to be doubly sure that the bleeding...

Telling patients about my experiences years ago, who bled to death from their varices, often convinces them to be more compliant.