211. Back to Basics - Hepatocellular Carcinoma

For over a decade, sorafenib remained unchallenged as first-line therapy for hepatocellular carcinoma, based on the SHARP trial, which showed survival increasing from 7.9 to 10.7 months. This demonstrated modest efficacy in a disease notoriously resistant to systemic treatment. That drought broke in 2020, when IMbrave150 demonstrated that atezolizumab plus bevacizumab beat sorafenib outright, pushing median survival past 19 months and putting immunotherapy on the map for liver cancer. Two years later, HIMALAYA proved that a single priming dose of anti-CTLA-4 could unlock durable responses, with the STRIDE regimen nearly doubling five-year survival compared with sorafenib. Then IMbrave050 asked whether that success could move earlier, into the adjuvant setting after resection — and the early promise didn’t hold up on longer follow-up. Together, these three trials mark both immunotherapy’s arrival in liver cancer and the limits of assuming it translates cleanly across settings.

Trials Discussed on Today's Episode:

HIMALAYA Trial

IMbrave 050

IMbrave 150

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Art courtesy of Taryn Silver

Music courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/

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