Advanced hepatocellular carcinoma presenting in a patient with Child-Turcotte-Pugh B cirrhosis requires careful patient selection before any systemic therapy is offered. Evidence-based options are available for well-selected individuals in this hepatic reserve class.
This protocol addresses advanced hepatocellular carcinoma in the specific context of Child-Turcotte-Pugh B cirrhosis (well-selected patients). The underlying degree of hepatic impairment in this class is a central determinant of which systemic approaches are appropriate and how patient tolerability is weighed.
For well-selected patients in this setting, systemic therapy may be considered. Options span targeted agents and immune checkpoint inhibitors, though agent choice depends on individual patient characteristics outlined in the full protocol.
DOI: 10.1097/HEP.0000000000000466
Well-selected patients with Child-Turcotte-Pugh B cirrhosis may be offered sorafenib, lenvatinib, or single-agent anti-PD1 or anti-PDL1 ICI therapy (Level 3, Weak Recommendation).
View source ↗