New combo therapy aims to stop liver cancer spread in its tracks

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Age 18 to 75 years * Hepatocellular carcinoma confirmed by imaging and/or histology according to institutional diagnostic standards * Advanced or unresectable disease with extrahepatic metastases meeting protocol-defined oligo-extrahepatic metastatic disease criteria: 1 to 5 extrahepatic metastatic lesions and no more than 2 involved extrahepatic organs * At least 1 measurable lesion according to RECIST version 1.1 * No prior systemic therapy for advanced or metastatic hepatocellular carcinoma * ECOG performance status 0 to 1 * Child-Pugh class A or stable Child-Pugh B7 * Adequate hematologic, hepatic, renal, and coagulation function according to protocol * Baseline center multidisciplinary team assessment indicating potential feasibility for complete consolidative intent if disease control is achieved after induction * Written informed consent and willingness to comply with treatment, follow-up, and protocol-required assessments Exclusion Criteria: * More than 5 extrahepatic metastatic lesions or more than 2 involved extrahepatic organs * Diffuse peritoneal seeding, leptomeningeal disease, or uncontrolled brain metastases * Main portal vein trunk invasion, extensive inferior vena cava or right atrial tumor thrombus, or disease considered unlikely to become fully consolidable after induction * Diffuse intrahepatic disease or liver tumor burden considered unlikely to be controllable with protocol-specified local treatment * Prior PD-1, PD-L1, CTLA-4, anti-VEGF monoclonal antibody, tyrosine kinase inhibitor, or other systemic antitumor therapy for advanced HCC * Active autoimmune disease requiring systemic immunosuppression * Active severe infection, including uncontrolled bacterial or fungal infection, active tuberculosis, or uncontrolled hepatitis B without appropriate antiviral therapy * Gastrointestinal bleeding within the previous 6 months, or untreated or uncontrolled high-risk gastroesophageal varices * Uncontrolled hypertension, recent major thrombotic event, myocardial infarction, unstable angina, or stroke * Active interstitial lung disease or noninfectious pneumonitis requiring systemic treatment * Severe proteinuria or renal dysfunction considered unsuitable for lenvatinib treatment * Pregnancy or breastfeeding * Any condition that, in the investigator's judgment, would make participation unsafe or compromise protocol compliance