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HCC — SCE Medical Oncology MCQ

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HardGI CancersHCCSCE Medical Oncology

Advanced hepatocellular carcinoma progresses after sorafenib. Liver function is Child-Pugh A and ECOG performance status is 1. Which NICE-recommended oral treatment is available in this exact post-sorafenib population?

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Correct answer: B — Cabozantinib

Explanation lettering: E = shown as A · C = shown as B · B = shown as C · A = shown as D · D = shown as E

C is correct. NICE TA849 recommends cabozantinib after sorafenib for adults with Child-Pugh A liver impairment and ECOG 0 or 1. Lenvatinib and atezolizumab-bevacizumab are first-line pathways rather than treatments appraised by TA849 after sorafenib. Nivolumab-ipilimumab and pembrolizumab do not have the same routine NICE recommendation in this exact sequence. Regorafenib is another post-sorafenib option in suitable patients but is deliberately not listed because the question asks for the treatment defined by TA849. The original question incorrectly extrapolated cabozantinib eligibility to progression after atezolizumab-bevacizumab.

Reference: NICE TA849 cabozantinib recommendations: https://www.nice.org.uk/guidance/ta849/chapter/1-Recommendations