What is your treatment approach for a patient with metastatic hepatocellular carcinoma with Child's Pugh B cirrhosis?
How do you sequence systemic treatment options for in patients with Child's Pugh B (or greater) in context of IMbrave150 and HIMALAYA?
When do you incorporate immunotherapy?
Answer from: Medical Oncologist at Community Practice
Child Pugh B cirrhosis is a spectrum of disease, and requires careful consideration of the underlying cause of the cirrhosis as well as the potential impact of cancer therapy. As @Ghassan K. Abou-Alfa pointed out, there is data for sorafenib in this patient population, demonstrating a similar relati...
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Medical Oncologist at Gaston Hematology and Oncology Thanks.
Answer from: Medical Oncologist at Academic Institution
I agree with the above comments. The data is, unfortunately, limited for some of the novel agents we have in first line including IMbrave150 and HIMALAYA for Child Pugh B or higher.Having said that, clinically, if a patient has CP of 7 and is functionally well, I do not hesitate to consider atezoliz...
Answer from: Medical Oncologist at Academic Institution
Data driven treatment of patients with advanced HCC and Child Pugh B cirrhosis are limited to first line sorafenib (Miller et al., PMID 19255312) and nivolumab (Kambhampati et al., PMID 31154669). Child Pugh is an exponential spectrum, and early Child Pugh B deserves a serious look. Child-Pugh consi...
Thanks.