TACE Plus Atezolizumab/Bevacizumab and I-125 Seeds Brachytherapy for HCC With Branch PVTT

Prior treatment

• Evidence or history of bleeding diathesis or any hemorrhage or bleeding event \>CTCAE grade 3 within 4 weeks prior to randomization;
• A prior bleeding event due to esophageal and/or gastric varices within 6 months prior to initiation of study treatment;

Other illness

• Any condition representing a contraindication to TACE or I-125 seeds brachytherapy as determined by the investigators;
• Active or history of autoimmune disease or immune deficiency;
• Untreated or incompletely treated esophageal and/or gastric varices with bleeding or high risk for bleeding;
• Evidence of bleeding diathesis or significant coagulopathy;
• Significant cardiovascular disease;
• Severe infection, such as active tuberculosis;
• History of organ or cells transplantation;
• History of other uncurable malignancies.

Other

• Diffuse HCC;
• Cholangiocarcinoma, fibrolamellar, sarcomatoid hepatocellular carcinoma, and mixed hepatocellular/cholangiocarcinoma subtypes (confirmed by histology, or pathology) are not eligible;
• Evidence of extrahepatic spread (EHS);
• Pregnant or breastfeeding females;
• Serious medical comorbidities;

• Age between18 and 75 years;
• Has a diagnosis of HCC confirmed by radiology, histology, or cytology;
• Type I PVTT or type II PVTT;
• Child-Pugh class A;
• Eastern Cooperative Group performance status (ECOG) score of 0-1;
• No prior systemic therapy for HCC.
• Adequate hematologic and end-organ function;
• At least one measurable intrahepatic target lesion.