Low-Dose Bevacizumab and Atezolizumab Combined With TACE-HAIC in Unresectable Hepatocellular Carcinoma

This is a prospective, single‐arm, phase II clinical study designed to evaluate theefficacy and safety of low‐dose bevacizumab plus atezolizumab combined with transarterialchemoembolization followed by hepatic arterial infusion chemotherapy (TACE‐HAIC) asfirst‐line treatment for patients with unresectable hepatocellular carcinoma (HCC). Thestudy plans to enroll approximately 38 patients with unresectable, locally advanced HCCwho have not received prior systemic therapy.Although atezolizumab plus bevacizumab has become a standard first‐line treatment optionfor advanced HCC, the objective response rate remains limited. TACE‐HAIC may improvetumor control by increasing local chemotherapy exposure, promoting tumor antigen release,and enhancing the anti‐tumor activity of immunotherapy and anti‐angiogenic therapy. Inthis study, patients will receive TACE‐HAIC in combination with atezolizumab and low‐dosebevacizumab, followed by maintenance treatment with atezolizumab plus low‐dosebevacizumab until disease progression, unacceptable toxicity, withdrawal of consent, orother protocol‐defined discontinuation criteria.The primary endpoint is objective response rate (ORR) assessed by investigators accordingto RECIST version 1.1. Secondary endpoints include ORR by mRECIST, disease control rate,duration of response, progression‐free survival, time to progression, overall survival,and safety. This study aims to explore whether this combination strategy can provideimproved anti‐tumor activity with manageable safety in patients with unresectable HCC.