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An expert discusses how in the first-line (1L) treatment of advanced unresectable hepatocellular carcinoma (uHCC) with tyrosine kinase inhibitors (TKIs) such as lenvatinib or sorafenib, proactive adverse event (AE) management is crucial. This includes baseline assessment; regular monitoring of adverse effects such as hypertension, hand-foot syndrome, and fatigue; and implementing preventive strategies. Treatment should be individualized with dose modifications as needed to balance therapeutic efficacy with quality of life, particularly given the advanced disease state.

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The panelist discusses, for intermediate-stage unresectable hepatocellular carcinoma (uHCC), key clinical pearls include prioritizing transarterial chemoembolization (TACE) as a first-line therapy, with systemic options for TACE-ineligible patients or progression; consider lenvatinib or atezolizumab plus bevacizumab based on liver function and risk factors. Evaluate treatment success via a radiologic response (mRECIST criteria), AFP levels, and toxicity profiles; modify treatment upon radiologic progression, prohibitive toxicity, or declining performance status.

1 expert in this video

An expert discusses how recent analyses from the REFLECT trial in unresectable hepatocellular carcinoma (uHCC) demonstrate that both achieving objective response and greater depth of response correlate with improved survival outcomes. The depth of response serves as a potentially valuable early biomarker for prognosis and treatment decisions, with deeper responses associated with better overall survival among responders.