Updated ASCO HCC Guideline Offers New Recommendations for Patient Care

The American Society of Clinical Oncology (ASCO) has updated their 2020 guideline on systemic therapy for hepatocellular carcinoma (HCC).

The guideline was developed to help aid clinicians in the decision-making process for patients with advanced HCC. An Expert Panel was convened to develop new recommendations based on a systemic review of medical literature. This latest update is based on evidence from the CheckMate459 and IMbrave150 studies, as well as 10 randomized controlled trials published through October 2023 that met the inclusion criteria.

The latest guideline update includes recommendations for first-, second-, and third-line therapy options, as well as systemic therapy approaches for patients with Child-Pugh class A and B type disease. The updated recommendations include:

• Atezolizumab plus bevacizumab or durvalumab plus tremelimumab may be offered as first-line treatments for patients with Child-Pugh class A, and Eastern Cooperative Oncology Group (ECOG) performance status 0-1 advanced HCC.
• In the case of contraindications to atezolizumab plus bevacizumab or durvalumab plus tremelimumab, sorafenib, lenvatinib, or durvalumab may instead be offered as first-line treatment for patients with Child-Pugh class A disease and ECOG PS 0-1 advanced HCC.
• Following first-line treatment with durvalumab plus tremelimumab, second-line therapy with a tyrosine kinase inhibitor may be recommended.

The full guideline update can be found at the Journal of Clinical Oncology.