This research plan involves a treatment approach for advanced hepatocellular carcinoma (HCC) in the context of metabolic-associated steatotic liver disease (MASLD). The study aims to compare the efficacy differences between sequential therapy and concurrent therapy using bevacizumab and atezolizumab for advanced HCC in MASLD. The research will focus on evaluating objective response rates, progression-free survival, disease control rates, and overall survival, while utilizing biomarker analysis to elucidate treatment mechanisms. Additionally, the study will examine treatment safety, including the incidence and severity of adverse events.
ECOG performance status of 0-1
Preoperative imaging diagnosis of advanced hepatocellular carcinoma (BCLC stage C or D, unsuitable for surgery)
Ultrasound or MRI indicating moderate to severe fatty liver (Fibroscan CAP > 268 dB/m or MR fat score > 10%)
Willing to use contraceptive measures during the trial period
Excessive alcohol consumption (weekly ethanol intake: males < 210 g, females < 140 g)
Tumor lesions previously treated with targeted therapy, immunotherapy, TACE, or radiotherapy
Pregnant or breastfeeding women, or positive pregnancy test at baseline
Central nervous system metastases diagnosed by CT, MRI, or PET-CT