Episode # 57 • 28 Apr 2026
First-Line Therapy for Advanced Hepatocellular Carcinoma: Decisions in the Real World
Learn how a “watershed” clinical trial in 2020 completely overturned a decade of standard care for liver cancer. In this inaugural episode of the BackTable 2026 HCC Creator Weekend™ , medical oncologists Dr. John Rahi, Dr. Craig Lockhart, and Dr. Lingling Du review the evolution of first-line systemic therapy for hepatocellular carcinoma (HCC), highlighting immune checkpoint inhibitors as a major change from the TKI era.
Timestamps
00:00 - Introduction
03:24 - Early Immunotherapy Momentum
07:03 - Long Term Survival Tails
14:13 - Autoimmune Disease Nuances
22:45 - Combining With Liver Directed Therapy
25:29 - Ideal Candidate for Ipi Nivo
26:54 - Wrap Up and Takeaways
Resources
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More about this episode
The doctors discuss key data from IMbrave150 (atezolizumab/bevacizumab vs sorafenib), HIMALAYA (STRIDE: tremelimumab plus durvalumab vs sorafenib), and CheckMate 9DW (ipilimumab/nivolumab vs physician’s choice TKI, largely lenvatinib), noting improved survival, high response rates with ipi/nivo, and long-term survival “tails.” They cover negative/neutral TKI-IO trials (LEAP-002, COSMIC-312) and focus on patient selection nuances including EGD/variceal bleeding risk with bevacizumab, hypertension/proteinuria, platelet thresholds, autoimmune disease considerations, Child-Pugh status, liver function preservation, and preferences when combining systemic therapy with liver-directed procedures like Y90.
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