Applying Real-World Evidence to Frontline Regimen Selection in HCC

The panel discusses how to apply real-world evidence to frontline regimen selection in advanced hepatocellular carcinoma (HCC). The experts reflect on the multicenter retrospective comparison of atezolizumab plus bevacizumab and durvalumab-based therapy, noting that comparable median overall survival is reassuring precisely because atezolizumab plus bevacizumab was often used first and given to slightly sicker, bevacizumab-ineligible patients early in its adoption. James J. Harding, MD, and colleagues acknowledge the limitations of small, single-region retrospective datasets that are not powered to supplant prospective data, while emphasizing that outcomes typically appear less favorable when therapies move from trials into routine practice. The panel agrees the data support the utility of both regimens and reinforce a shift away from defaulting to bevacizumab. They look ahead to larger datasets and analytic approaches for understanding real-world populations, and stress that the comparable outcomes promote shared decision-making between clinicians and patients with advanced HCC.