What would be your first-line approach to a patient with metastatic HCC with significant bleeding risk?
Patients oftentimes have cardiac co-morbidities with requirement for anti-coagulation making TKIs, including Bevacizumab, difficult to dose. Would the level of AFP elevation sway your decision?
2 Answers
Mednet Member
Medical Oncology · Northwell Health System
Answered on · Updated on
Single-agent nivolumab or pembrolizumab. I would favor pembrolizumab given that nivolumab was removed from the market for this indication.
Join for free or sign in to see the full answer
Mednet MemberInvited Expert
Medical Oncology · University Hospitals
Answered on
There is increased risk of variceal bleed with atezolizumab plus bevacizumab. Therefore, EGD is recommended in all patients. The patient can still receive the combination if on anticoagulants.
If someone has high risk of variceal bleed, lenvatinib can be used as first line therapy. Lastly, single ag...
Join for free or sign in to see the full answer