This study is a prospective, multicenter Phase II trial evaluating a personalized treatment strategy for patients with unresectable hepatocellular carcinoma (HCC). The study uses a metabolic classification system called the fatty acid degradation (FAD) subtype to guide therapy selection. Patients will be assigned to different treatment groups based on their tumor's FAD subtype, determined through RNA-seq analysis of the tumor tissue obtained from liver biopsy.
Adults ≥18 years of age who voluntarily agree to participate and sign informed consent.
Histologically or cytologically confirmed hepatocellular carcinoma (HCC).
Unresectable or not suitable for curative local therapy, or progression after prior surgery or local therapy.
BCLC stage B or C.
Non-HCC primary liver cancers (e.g., cholangiocarcinoma, combined HCC-CCA).
F3 subtype without liver lesions on imaging.
Clinically significant ascites requiring therapeutic intervention, or uncontrolled pleural/pericardial effusion.
Interstitial lung disease, pneumonitis requiring steroids, or active pulmonary infection.