HEALTH PROFESSIONAL · SOURCE READING

Second-line systemic therapy

Source: Primary Liver Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.

Source updated: April 17, 2025 · Captured 2026-09-09.

Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary.

Context: Treatment of Locally Advanced or Metastatic Primary Liver Cancer / Treatment Options for Locally Advanced or Metastatic Primary Liver Cancer

TKIs (regorafenib, cabozantinib, and ramucirumab) and immune checkpoint inhibitors (pembrolizumab and combination nivolumab with ipilimumab) are approved for the second-line treatment of patients with advanced HCC who have progressed while receiving sorafenib. However, the most effective second-line treatment after first-line combination atezolizumab and bevacizumab has not been determined. Physicians may consider other therapies approved in the first line (e.g., lenvatinib after atezolizumab and bevacizumab or immune checkpoint inhibitors).

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Targeted therapy (multikinase inhibitors) →Combination immunotherapy and immunotherapy alone →

Preserved source evidence · Not medical advice