Systemic Therapy for Advanced Hepatocellular Carcinoma with Impaired Liver Function: Navigating the Evidence Gap. (PubMed, Cancers (Basel)) - Sep 27, 2026 - "Cohort 5 of the CheckMate 040 nivolumab trial included selected patients with CTP-B7/B8 disease and demonstrated modest efficacy, with an objective response rate of 12% and a median overall survival of 7.6 months. Additionally, the phase 3b single-arm SIERRA study reported a manageable safety profile for durvalumab plus tremelimumab (STRIDE regimen) in the CTP-B population. In contrast, regimens incorporating vascular endothelial growth factor (VEGF) inhibition, such as atezolizumab-bevacizumab and tyrosine kinase inhibitors (TKIs), may require cautious use due to an increased risk of bleeding or hepatic decompensation. TKIs, including sorafenib, lenvatinib, regorafenib, and cabozantinib, are metabolized by hepatic CYP450 pathways and require careful patient selection, monitoring, and dose optimization...Decreased liver reserve represents a heterogeneous clinical state, and treatment benefits depend on maintaining treatment duration without precipitating hepatic..."
Journal • Review • Cardiovascular • CNS Disorders • Fibrosis • Hepatocellular Cancer • Hepatology • Hypertension • Immunology • Liver Failure • Oncology • Portal Hypertension • Solid Tumor
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Arathi Mohan; Hannah Abraham; Maisha Anika; Nataliya Razumilava; Oxana V Crysler
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