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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?
Answer from: Medical Oncologist at Community Practice
Single agent nivolumab or pembro.
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Answer from: Medical Oncologist at Academic Institution
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 a...