Immunotherapy for recurrent hepatocellular carcinoma

Table 3 Possible treatment regimens for patients with advanced hepatocellular carcinoma who have recurred on local therapy

Patient group	Treatment	Status
Advanced HCC patients with no prior systemic therapy	Atezolizumab + bevacizumab	FDA approved for first-line use (no contraindications to atezolizumab/bevacizumab or both)
	Durvalumab + tremelimumab	Contraindications to atezolizumab or bevacizumab or both; FDA approved for first-line use
	Single agent immunotherapy	Poor ECOG 3-4
Advanced HCC with prior systemic therapy with TKIs like sorafenib or lenvatinib	Ipilimumab + nivolumab	FDA approved for second-line use
	Pembrolizumab	FDA approved for second-line use; High risk subgroups: Asian patients, poor ECOG
	Atezolizumab + bevacizumab	Warrants further evaluation
	Durvalumab + tremelimumab
	Clinical trials
HCC patients with prior IO based systemic therapy	Partner switching from currently available first-line options	Using drugs with different mechanism of action in comparison to first line IO therapy
	Pembrolizumab	Warrants further evaluation
	Ipilimumab + nivolumab
	Clinical trials

ECOG: Eastern cooperative oncology group; FDA: Food and drug administration; HCC: Hepatocellular carcinoma; IO: Immunotherapy; TKI: Tyrosine kinase inhibitor.