Integrating Quality of Life and Survival in Systemic Therapy for Advanced Hepatocellular Carcinoma

Among available first-line systemic therapy options for unresectable or advanced hepatocellular carcinoma, which treatment provides the optimal balance between overall survival benefit and preservation of health-related quality of life?In this network meta-analysis of 9 phase 3 randomized clinical trials including 6425 patients, atezolizumab plus bevacizumab showed the highest probability of reducing deterioration in most quality of life domains (global health status 85%, abdominal swelling 95%, jaundice 89%, pain 86%), whereas tislelizumab ranked highest for physical functioning (96%) and fatigue; when integrating quality of life with overall survival, atezolizumab plus bevacizumab significantly outperformed all other treatments across all assessed domains.These findings indicate that atezolizumab plus bevacizumab provides the optimal balance between survival benefit and preservation of quality of life compared to other first-line systemic therapy options in unresectable or advanced hepatocellular carcinoma, offering a more patient-centered approach for treatment selection.

Corresponding Author: David James Pinato, MD, MRes, PhD, Imperial College London Hammersmith Campus, Du Cane Road, London W12 0HS, United Kingdom (david.pinato@imperial.ac.uk).

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