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OncoMatch/Clinical Trials/NCT06339424

Atezolizumab and Bevacizumab With Photon Radiotherapy for Unresectable Hepatocellular Carcinoma

Is NCT06339424 recruiting? Yes, currently enrolling (May 2026). This Phase 2 trial studies multiple treatments including Atezolizumab and Bevacizumab for hepatocellular carcinoma.

Phase 2RecruitingChang Gung Memorial HospitalNCT06339424Data as of May 2026

Treatment: Atezolizumab · BevacizumabAtezolizumab (anti-programmed death-ligand 1; anti-PD-L1) in conjunction with bevacizumab (anti-vascular endothelial growth factor; anti-VEGF) has become the established standard first-line systemic treatment for unresectable hepatocellular carcinoma (HCC). Despite an improved objective response rate (ORR) of 27%, the majority of patients face HCC progression and liver failure \[Finn et al., N Engl J Med 2020\]. Developing a new combined treatment strategy to overcome resistance to anti-PD-L1 and anti-VEGF is essential to improve patient outcomes. Radiation treatment (RT) is highly efficacious in controlling localized solid tumors and has become an integral component of the treatment algorithm for unresectable HCC. Importantly, a recent retrospective cohort described that RT combined with atezolizumab plus bevacizumab was associated with favorable median overall survival of 16.1 months (Manzar et al, Cancers 2022). Our preclinical study (Hsieh et al., Science Immunology 2022) revealed that RT combined with PD-L1/PD-1 blockade induces immunogenic cell death and tumor antigen cross-presentation in antigen-presenting cells, thereby potentiating the systemic antitumor T cell responses in murine tumor models. However, whether the combinatorial therapy with RT, atezolizumab, and bevacizumab can trigger synergistic antitumor effects and systemic immune mobilization has not yet been validated in clinical trials for unresectable HCC. Both atezolizumab/bevacizumab and X-ray RT are approved treatment methods for unresectable HCC by the U.S. and Taiwan Food and Drug Administration (FDA). The present phase II non-randomized trial aims to prospectively document the therapeutic efficacy, safety, and immunological responses in patients with unresectable HCC treated with atezolizumab/bevacizumab combined with conventional photon radiotherapy.

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Extracted eligibility criteria

Cancer type

Hepatocellular Carcinoma

Disease stage

Required: Stage BARCELONA CLINIC LIVER CANCER (BCLC) STAGES INTERMEDIATE (B) OR ADVANCED (C) (BCLC)

Barcelona Clinic Liver Cancer (BCLC) stages Intermediate (B) or Advanced (C). Participants must have a diagnosis of HCC that is deemed unsuitable for surgical resection or transplant.

Performance status

ECOG 0–1(Restricted strenuous activity)

Prior therapy

Cannot have received: radiation therapy

Exception: to the region of the liver that would result in overlap of radiation therapy fields

Prior radiotherapy to the region of the liver that would result in overlap of radiation therapy fields

Cannot have received: selective internal radiotherapy/hepatic arterial yttrium therapy

Prior selective internal radiotherapy/hepatic arterial yttrium therapy, at any time

Cannot have received: solid organ transplantation

Prior solid organ transplantation

Lab requirements

Blood counts

Hemoglobin ≥ 9.0 g/dL; Absolute neutrophil count (ANC) ≥ 1,000/mm3; Platelet count ≥ 50,000/μL

Kidney function

Serum creatinine ≤ 1.5 mg/dL

Liver function

Total bilirubin < 2.5 mg/dL; Serum albumin >2.8 g/dL; Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3 × upper limit of normal (ULN); Prothrombin time ≤ 6 seconds prolonged; Child-Pugh score 5-6 liver function within 28 days of study registration

Adequate bone marrow, liver, and renal function within 4 weeks before study registration * Hemoglobin ≥ 9.0 g/dL * Absolute neutrophil count (ANC) ≥ 1,000/mm3 * Platelet count ≥ 50,000/μL * Total bilirubin < 2.5 mg/dL * Serum albumin >2.8 g/dL * Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3 × upper limit of normal (ULN) * Prothrombin time ≤ 6 seconds prolonged * Serum creatinine ≤ 1.5 mg/dL Child-Pugh score 5-6 liver function within 28 days of study registration

Structured fields extracted by AI. May contain errors — verify against the official protocol.

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