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Finn et al. Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma. N Engl J Med. 2020;382:1894-1905. PMID 32402160

One-paragraph summary

IMbrave150 randomized untreated unresectable HCC to atezolizumab plus bevacizumab or sorafenib. The combination improved overall and progression-free survival, establishing combined immune-checkpoint and VEGF inhibition as a first-line standard.

Key findings

  • The trial displaced sorafenib as default first line for eligible patients.
  • Response and quality-of-life results supported a clinically meaningful change.
  • Variceal/bleeding evaluation was integral to safe bevacizumab use.

Limitations

  • Predominantly Child-Pugh A and performance-preserved population.
  • Excluded important transplant, autoimmune, and bleeding-risk groups.
  • Does not rank later IO combinations or define post-progression sequencing.

Why it matters

IMbrave150 transformed HCC from a TKI-first disease into an immunotherapy-combination disease and moved bleeding preparation into the treatment algorithm.

Cited by wiki pages

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