Opening Remarks and the Frontline Treatment Landscape in Advanced HCC

In this Cancer Network Face Off program on advanced hepatocellular carcinoma (HCC), moderator Rachna T. Shroff, MD, welcomes two expert teams and outlines the format before setting the clinical stage. Shroff reviews the current NCCN frontline recommendations for advanced HCC, walking through the category 1 preferred regimens atezolizumab plus bevacizumab and tremelimumab plus durvalumab, along with the recommended option nivolumab plus ipilimumab. She traces the expansion of first-line therapy through the FDA approvals of atezolizumab plus bevacizumab in 2020, tremelimumab plus durvalumab in 2022, and nivolumab plus ipilimumab in 2025. Shroff emphasizes that treatment selection should reflect tumor burden, liver reserve, variceal and bleeding risk, performance status, and the ability to manage immune-related toxicity. She also highlights the NCCN footnote on the increased incidence of early death during the first 6 months with nivolumab plus ipilimumab, framing the data-driven discussion to follow in the frontline setting.