A Generative Model-based System for Predicting Survival and Guiding Treatment Decisions in Patients With Unresectable Hepatocellularcarcinoma Undergoing Transcatheter Arterial Chemoembolization in Combination With Immunotherapy and Targeted Therapy

Prior treatment

• Concurrent presence of other malignant tumors besides HCC;
• Moderate to severe ascites (ascites scoring 3 points on the Child-Pugh scale); - - Receipt of other first-line, second-line, or third-line systemic therapies (including any regimen of systemic treatment) or any local therapies (including transcatheter interventional therapy, ablation therapy, internal/external radiotherapy, etc.), as well as surgical resection or herbal medicine within 4 weeks prior to TACE combined with targeted immunotherapy;

Other illness

• Co-infection with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS);
• Acute or chronic psychiatric disorders (including those affecting participant enrollment, treatment intervention, or follow-up).

Lab values

• Incomplete data, such as missing baseline laboratory test results, unavailable or poor-quality imaging data, or lack of prognostic information;
• Severe liver dysfunction: e.g., decompensated cirrhosis or other liver diseases significantly affecting bilirubin levels;
• Severe comorbidities: e.g., refractory hypertension (blood pressure remaining above 150/100 mm Hg despite optimal medication), persistent arrhythmia (CTCAE grade 2 or higher), atrial fibrillation of any degree, prolonged QTc interval (\>450 ms in males or \>470 ms in females), renal insufficiency, etc.;

Other

• Pregnant or breastfeeding women;

• Diagnosed as unresectable hepatocellular carcinoma (HCC) by histopathology and/or clinical diagnosis (typical imaging features, clinical manifestations, laboratory tests, etc.) (Reference: Guidelines for Diagnosis and Treatment of Primary Liver Cancer (2024 Edition));
• Patients with unresectable HCC receiving TACE combined with targeted immunotherapy;
• Liver function classified as Child-Pugh A or B;
• Aged 18 or above, regardless of gender;
• Expected survival time ≥3 months;
• ECOG PS score ≤2;
• Meeting the following laboratory parameters: a) Hematologic function: Absolute neutrophil count ≥1.0×10⁹/L; Platelet count ≥50×10⁹/L; Hemoglobin ≥90 g/L; International normalized ratio (INR) \<1.7 or prothrombin time prolongation ≤4 seconds; b) Liver function: ALT/AST ≤5× upper limit of normal (ULN); Total bilirubin ≤210 μmol/L \[≤2.38 mg/dL\]; Albumin ≥28 g/L; c) Renal function: Serum creatinine ≤1.5× ULN.