What would be your first-line approach to a patient with metastatic HCC with significant bleeding risk?

Single-agent nivolumab or pembrolizumab. I would favor pembrolizumab given that nivolumab was removed from the market for this indication.

There is increased risk of variceal bleed with atezolizumab plus bevacizumab. Therefore, EGD is recommended in all patients. The patient can still receive the combination if on anticoagulants.

If someone has high risk of variceal bleed, lenvatinib can be used as first line therapy. Lastly, single ag...