Study aid only. Verify against current guidelines, primary literature, staging manuals, and prescribing information before clinical use.

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Advanced Hepatocellular Carcinoma — Systemic Therapy

First-line Second-line SECOND-LINE Advanced HCC Child-Pugh A First-line (IO-based) Second-line Preferred Atezolizumab + bevacizumab IMbrave150 ↗ Dual-IO Durvalumab + tremelimumab HIMALAYA ↗ If IO C/I Lenvatinib or sorafenib REFLECT ↗ TKI Regorafenib RESORCE ↗ TKI Cabozantinib CELESTIAL ↗ AFP-high Ramucirumab REACH-2 ↗