Child-Pugh B or C cirrhosis in HCC patient. CP-A is the only fully- studied class for ICI...

Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.

ID	`RF-HCC-CHILD-PUGH-B-C`
Type	Signal d’alerte
État	reviewed 2026-04-26 \| pending_clinical_signoff
Maladies	`DIS-HCC`
Sources	`SRC-AASLD-HCC-2023` `SRC-NCCN-HCC-2025`

Origine du drapeau rouge

Définition	Child-Pugh B or C cirrhosis in HCC patient. CP-A is the only fully- studied class for ICI combinations (atezo+bev, durva+treme); CP-B has partial sorafenib/lenvatinib data but worse safety; CP-C generally precludes systemic therapy (focus on supportive care + transplant evaluation if liver-limited disease).
Direction clinique	désescalade
Catégorie	dysfonction d'organe
Algorithme de décalage	ALGO-HCC-SYSTEMIC-1L

Logique de déclenchement

{
  "any_of": [
    {
      "finding": "child_pugh_class",
      "value": "B"
    },
    {
      "finding": "child_pugh_class",
      "value": "C"
    }
  ],
  "type": "composite_score"
}

Notes

Child-Pugh score assesses encephalopathy, ascites, bilirubin, albumin, INR. CP-B: ICI-bev contraindicated (anti-angiogenic stress on decompensated liver); sorafenib partial data (GIDEON registry). CP-C: best supportive care + hepatology / transplant; systemic chemo not indicated.

Utilisé par

Algorithmes

ALGO-HCC-SYSTEMIC-1L - ALGO-HCC-SYSTEMIC-1L
ALGO-HCC-SYSTEMIC-2L - ALGO-HCC-SYSTEMIC-2L

Indication

IND-HCC-SYSTEMIC-1L-ATEZO-BEV - IND-HCC-SYSTEMIC-1L-ATEZO-BEV
IND-HCC-SYSTEMIC-1L-DURVA-TREME - IND-HCC-SYSTEMIC-1L-DURVA-TREME
IND-HCC-SYSTEMIC-1L-SORAFENIB - IND-HCC-SYSTEMIC-1L-SORAFENIB
IND-HCC-SYSTEMIC-2L-CABOZANTINIB - IND-HCC-SYSTEMIC-2L-CABOZANTINIB
IND-HCC-SYSTEMIC-2L-RAMUCIRUMAB - IND-HCC-SYSTEMIC-2L-RAMUCIRUMAB
IND-HCC-SYSTEMIC-2L-REGORAFENIB - IND-HCC-SYSTEMIC-2L-REGORAFENIB

Signal d’alerte

RF-ORGAN-HEPATIC-CHILD-PUGH-B - Moderate hepatic dysfunction (Child-Pugh B, score 7-9). Triggers dose modification or sub...