Would you use upfront atezo/bev in a patient with HCC and untreated hepatitis?

In the case of a patient with untreated chronic hepatitis C, I would offer upfront atezo/bev, as long as hepatic function is appropriate. At our center, hepatitis C treatment is generally not offered to patients with advanced HCC.

Interestingly, only 21% of patients treated with atezolizumab/bevaciz...

Yes. I would not have concerns. For HBV, I would start treatment before or simultaneously. Studies have varied by protocol about the HBV viral load being under 500 or 100 but it is not clear this matters. There have not been flairs reported. In regards to HCV, again, not an issue for me.

Patients with hepatitis B should be on antiviral therapy with HBV DNA level of 500 or less; all trials with immune checkpoint inhibitors have had such a requirement. There are no limitations or special requirements in regards to treatment of Patients for hepatitis C prior to initiation of hepatitis ...