This study aims to identify early predictors for successful liver cancer treatment conversion. We will track changes in immune cells (CD8+ T-cells) in the blood during chemotherapy infusion (HAIC/TACE) combined with targeted-immunotherapy for 120 patients with unresectable liver cancer. By analyzing blood and tissue samples at multiple timepoints using advanced cell profiling and multi-omics sequencing, we seek to:

Determine if early immune cell changes predict tumor shrinkage; Identify tissue biomarkers linked to longer recurrence-free survival; Build a personalized prediction model for treatment outcomes.

Inclusion Criteria:

• Adults (18-75 years) with histologically confirmed HCC
• At least one measurable lesion ≥10 mm
• Planned HAIC/TACE + immunotherapy regimen
• Child-Pugh class A liver function
• ECOG 0-1
• Signed informed consent

Exclusion Criteria:

• Prior systemic HCC therapy within 6 months
• Main portal vein tumor thrombosis (VP4)
• Active autoimmune disease requiring immunosuppression
• HIV/HBV/HCV with uncontrolled viral replication
• Pregnancy or refusal of contraception

Adults with unresectable liver cancer (HCC) who are scheduled to receive HAIC/TACE plus immunotherapy at major hospitals in Shanghai. All participants must have preserved liver function (Child-Pugh A) and at least one measurable tumor. Key requirements include willingness to undergo tumor biopsy before treatment and provide repeated blood samples during therapy. Expected recruitment sources: 1) Liver cancer specialty clinics (majority), 2) Interventional radiology units.