Hepatocellular Carcinoma   

Previously untreated

The patient already received PLADO+sorafenib, Y90, and Atezolizumab/Bevacizumab complicated by recurrent episodes of bleeding from esophageal varices....

Would you offer liver transplant in the setting of metastatic disease? 

Would you try atezolizumab/bevacizumab or switch to a TKI?

For example in a patient with a history of PE?

i.e. EGD surveillance for varices?

What parameters do you use to decide to treat beyond progression? Is there any efficacy data from this specific study subgroup in IMbrave150?

ex. VEGFR2 expression, inflammatory signature, PDL1, etc.

Do you continue atezolizumab alone? Would you avoid anticoagulation?

In light of the SIRveNIB trial results and now IMbrave150, what is the role of intra-arterial therapy now?

Do you screen even asymptomatic patients?