Hepatocellular carcinoma（HCC）, one of the most common malignant tumors in China, severely threatens the life and health of patients. In recent years, precision medicine, clinical diagnoses, treatments, and innovative research have led to important breakthroughs in HCC care. The discovery of new biomarkers and the promotion of liquid biopsy technologies have greatly facilitated the early diagnosis and treatment of HCC. Progress in targeted therapy and immunotherapy has provided more choices for precise HCC treatment. Multiomics technologies, such as genomics, transcriptomics, and metabolomics, have enabled deeper understanding of the occurrence and development mechanisms, heterogeneity, and genetic mutation characteristics of HCC. The continued promotion and accurate typing of HCC, accurate guidance of treatment, and accurate prognostication have provided more treatment opportunities and prolonged survival timelines for patients with HCC. Innovative HCC research providing an in-depth understanding of the biological characteristics of HCC will be translated into accurate clinical practices for the diagnosis and treatment of HCC.

e16115 Background: The efficacy of first-line ICIs combination therapy patients with advanced hepatocellular carcinoma (HCC) was better than that of TKIs alone. This study was conducted to explore whether regorafenib combined with ICIs has better efficacy in second-line therapy. Methods: This retrospective study included 101 patients who have received regorafenib after the failure of at least one molecular-targeted therapy evaluated between March 2017 to November 2021. The patients were divided into two groups based on receiving regorafenib (cohort A) or regorafenib combined with ICIs(cohort B). The primary endpoint was Progression-Free Survival (PFS), and the secondary endpoints included the Objective Response Rate (ORR), Disease Control Rate (DCR), Overall Survival (OS), and safety. Results: 29 patients were in the cohort A and 72 were in the cohort B. There were no significant differences in age, gender, weight, ECOG performance status, Child-Pugh, BCLC staging, and the proportion of previous therapy regimens between the two cohorts. Among them, the first-line therapy mainly includes sorafenib, lenvatinib with or without ICIs. The median PFS (4.0 months), 6 months PFS rate (25.66%) and DCR(65.52%) of cohort A were poor than that of cohort B (8.7 months, 83.33%, 74.13%), (P＜0.05). OS data was not yet available. First-line therapy, use of TKI with ICIs (n = 31) or TKI without ICIs(n = 27) (PFS 8.70m VS 8.37m，P = 0.84), use of sorafenib with or without ICIs (n = 22), or lenvatinib with or without ICIs (n = 33)(PFS 8.87m VS 7.60m，P = 0.77), didn’t affect the PFS and ORR of the later line therapeutic regimens. In the cohort B, the ORR of the second-line (29.31%) was better than that of the third-line (0), (P = 0.03). Adverse events (AEs) of all grades were statistically different between the two groups (P = 0.03), but there was no significant difference in the incidence of grade 3-4 AE. Conclusions: In the later-line therapy, regorafenib combined with ICIs therapy showed better curative effect, especially in the second-line. Regorafenib combined with ICIs is recommended as early as second-line therapy to benefit patients. Different regimens of first-line therapy have no effect on PFS in second-line therapy.[Table: see text]

e16112 Background: Recently, atezolizumab plus bevacizumab (A+T) has shown promising effects on hepatocellular carcinoma (HCC). So far, no study explored the effectiveness and safety of A+T combined with interventional therapy in patients with HCC. This study aimed to explore short-term efficacy and safety of A+T combined with interventional therapy in first-line treatment of advanced HCC. Methods: In this retrospective study, 13 advanced HCC patients received first-line A+T combined with interventional therapy from September 2020 to September 2021 were enrolled. Liver function was evaluated by Child-Pugh score. Objective response rate (ORR), disease control rate (DCR), progression free survival (PFS) and adverse events (AEs) were recorded in accordance with RECIST v1.1 and CTCAE v5.0. The PFS was defined as the time from first dosing of A+T or first time of interventional therapy until disease progressive or death. Results: A total of 13 HCC patients with Barcelona Clinic Liver Cancer (BCLC) stage C were reviewed. The liver function of 8 patients was Child-Pugh A while the other 5 patients was Child-Pugh B. Median time of following up was 8.9 (5.2-12.6) months. The ORR and DCR were 30.8% and 84.6%, respectively. One patient was able to conduct hepatectomy after treatment. And CR was confirmed by pathological report after surgery. The median PFS was 9.7 (7.3-12.1) months. The 3-month PFS rate was 84.6%. Nearly all patients suffered from AEs. The most frequency AE were hyperthyroidism (6 of 15), following hypertension (4 of 15), weight loss (4 of 15). While platelet-cell- decrease (3 of 15) turn out to be the most frequent serious AE, but it could be well managed. No AE-related death happened. Total two patients died, of progression of tumor and septic shock respectively. Conclusions: A+T combined with interventional therapy showed potential short-term anti-tumor effect and tolerance on advanced HCC.[Table: see text]