Concurrently vs Sequentially Combined HAIC With Targeted and Immunotherapy in Potentially Resectable HCC

Inclusion Criteria:

1. Age ≥18 and ≤75 years;

2. ECOG PS score of 0~1;

3. Clinical or pathological diagnosis of hepatocellular carcinoma and meeting the stageIIa-IIIa of CNLC staging according to the relevant definitions in the 2015 editionof the Guidelines for Standardized Pathological Diagnosis of Primary Liver Cancer;

4. Not having received previous treatment against hepatocellular carcinoma;

5. Those who cannot be surgically resected after discussion by the multidisciplinaryteam of the participating centers , but have a potential chance of resection afterconversion therapy, including: multiple tumors located in one lobe of the liver;portal vein cancer thrombus not reaching the main trunk, which can be resectedtogether with the primary focus;

6. Laboratory tests meet the following conditions, or the following conditions can beachieved with short-term treatment: Neutrophil count ≥2.0×109/L; Hemoglobin ≥ 100 g/L; Platelet count ≥ 75 × 109/L;Plasma albumin level ≥ 35 g/L; Plasma total bilirubin less than 2 times the upperlimit of normal; Plasma alanine aminotransferase (ALT) less than 3 times the upperlimit of normal; Plasma aspartate aminotransferase (AST) less than 3 times the upperlimit of normal; Plasma creatinine less than 1.5 times the upper limit of normal;Plasma prothrombin time is normal or exceeds the upper limit of normal value by ≤ 4seconds; Prothrombinogen international normalized ratio (INR) ≤ 2.2;

7. Patients were fully informed about the study and signed an informed consent form.

Exclusion Criteria:

1. Those with severe comorbidity including cardiac, cerebral, pulmonary, renal, andother vital organ function damage, combined with severe infections or other seriousconcomitant diseases (> grade 2 CTCAE Version 5.0 adverse events), who cannottolerate the treatment;

2. Those with a history of other malignant tumors;

3. Those with a history of related drug allergy;

4. Those with known hypersensitivity to any component of the targeted and immunologicdrugs to be applied;

5. Those with a history of organ transplantation;

6. Those who have received previous treatment targeting hepatocellular carcinoma (including interferon);

7. Those with co-infection with HIV;

8. Those with drugs abuse;

9. Those who have had gastrointestinal bleeding or cardiovascular events within thelast 30 days;

10. Pregnant or breastfeeding women, or women of childbearing age who do not wish to usecontraception;

11. Persons with concomitant psychiatric disorders that preclude informed consent oraffect acceptance of treatment;

12. Other factors that may affect patient enrollment and assessment results.