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We read with interest the recent Gut roundtable paper by Gerbes et al. As highlighted by these authors, treatment of HCC has rapidly changed1: currently, four tyrosine kinase inhibitors, ramucirumab and two immune checkpoint inhibitors (ICP) are approved in different lines of treatment.2 3 Survival of patients with advanced disease have improved correspondingly, and more progress is expected from the burgeoning of trials of ICP-based combination treatment schemas (figure 1).
Due to the increasing efficacy of pharmacological treatment, many physicians are inclined to initiate systemic therapy, rather than trans-arterial chemoembolisation …
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