The safety, clinical efficacy and prognostic factors of transcatheter arterial chemoembolization (TACE) and/or hepatic artery infusion chemotherapy (HAIC) combined with targeted immunotherapy for primary hepatocellular carcinoma (HCC) require further in-depth study. This research aims to evaluate the safety, clinical efficacy and prognostic factors of TACE and/or HAIC combined with targeted immunotherapy for hepatocellular carcinoma.

We are going to compare and analyze local tumor response, survival outcomes, prognostic factors and adverse events. Tumor response was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) version. Adverse events were evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. This study intends to include the targeted and immunotherapy applied, mainly including: lenvatinib, sorafenib, apatinib, bevacizumab, etc.; pembrolizumab, carfilzomib, sintilimab and teprotumumab, etc.

Inclusion Criteria:

• aged 18-80 years
• Eastern Cooperative Oncology Group (ECOG) performance status score < 2
• maximum tumor diameter ≥ 7 cm
• IVC/RA TT diagnosed by contrast-enhanced CT / MRI before study treatment
• unresectable HCC (uHCC) confirmed by a specialized multidisciplinary team
• liver function of Child-Pugh class A or B

Exclusion Criteria:

• with other malignancies
• prior anti-tumor therapy
• history of drug allergy
• autoimmune diseases
• digestive hemorrhage of any grade
• insufficient renal, bone marrow, or coagulation function

120 HCC patients who underwent TACE and/or HAIC combined with molecular-targeted therapy and immunotherapy between January 2021 and December 2025 were enrolled.