New Study Looks at Shunt Procedure for Liver Cancer Patients

Hepatocellular carcinoma is a major cause of cancer death, often caught late. Most patients have cirrhosis and high blood pressure in the liver. The usual first‑line treatment is a combo of atezolizumab and bevacizumab. But this combo can cause bleeding, especially when portal hypertension is present. That makes it hard to keep treating.

A new real‑world study called NISTIPS TRITICC‑4 is looking at whether adding a TIPS helps. The study will follow up to 350 adults with cirrhosis and advanced liver cancer. These patients will get the standard combo or the combo without the TIPS, as doctors normally decide. The research will be done in many hospitals across Germany.

The main goal is to see how long it takes for liver function to get worse, defined as a steady drop in lab values for more than four weeks. Other goals include how long patients live, how long they stay on the drug, how well the tumor shrinks, when new spots appear or they die, and safety issues like bleeding or TIPS problems. Researchers will use survival curves and statistical models, and they will match patients to reduce bias.

The findings could show if a shunt procedure makes treatment safer or more effective for this high‑risk group. The trial is registered on clinicaltrials.gov with ID NCT07365930.