Choosing Between Atezolizumab-Bevacizumab and STRIDE in First-Line Advanced Hepatocellular Carcinoma
Abstract: Background: First-line systemic therapy for advanced hepatocellular carcinoma (HCC) has shifted toward immune-based combinations, particularly Atezolizumab plus Bevacizumab and the STRIDE regimen (single-dose Tremelimumab plus Durvalumab). Selecting between these regimens remains a common clinical challenge. Evidence Base: IMbrave150 demonstrated significant improvements in overall survival, progression-free survival, and response rates with Atezolizumab plus Bevacizumab versus Sorafenib. HIMALAYA demonstrated overall survival benefit with STRIDE, with durable long-term survival in a subset of patients. Differences in eligibility criteria, patient populations, and trial design limit direct comparison. Comparative Interpretation: Atezolizumab plus Bevacizumab appears preferable when rapid tumour response and progression control are priorities and anti-VEGF therapy is safe. STRIDE offers a VEGF-free alternative, particularly relevant for patients with bleeding risk or contraindications to Bevacizumab. Clinical Selection: Treatment selection should consider liver reserve, portal hypertension, bleeding risk, autoimmune disease, transplant context, and therapeutic goals. Conclusion: Both regimens are clinically important first-line options. Optimal treatment selection should be individualized according to patient characteristics, disease biology, and treatment feasibility.
Keywords: Hepatocellular carcinoma, advanced HCC, atezolizumab, bevacizumab, tremelimumab, durvalumab, STRIDE regimen, immunotherapy, first-line systemic therapy
How to Cite?: Praloy Basu, Rajan Yadav, Goutham Sunny, Abinash Patnaik, "Choosing Between Atezolizumab-Bevacizumab and STRIDE in First-Line Advanced Hepatocellular Carcinoma", Volume 15 Issue 5, May 2026, International Journal of Science and Research (IJSR), Pages: 1243-1249, https://www.ijsr.net/getabstract.php?paperid=SR26520174441, DOI: https://dx.doi.org/10.21275/SR26520174441