Considering STRIDE for Child-Pugh B7 and Other Underrepresented Patients

The panel discusses whether the SIERRA safety data support using the STRIDE regimen, tremelimumab plus durvalumab, in patients typically excluded from frontline hepatocellular carcinoma (HCC) trials. Team Chicago Hot Dog asks whether clinicians would choose STRIDE for patients with Child-Pugh B7 disease or reduced performance status based on these data. James J. Harding, MD, and colleagues respond that the safety profile is reassuring and supports treating selected, functional Child-Pugh B7 to B8 patients who are managing comorbid cirrhosis, addressing the common clinical concern of decompensating these patients with additional therapy. The experts note that the key unanswered question is whether treatment improves outcomes or response in this population, since efficacy data remain pending. Several panelists describe how the safety findings shift their practice toward offering combination immunotherapy rather than durvalumab monotherapy in poorer-prognosis patients, while awaiting mature efficacy results to fully define the role of STRIDE in underrepresented advanced HCC populations.