Durable complete response following sequential atezolizumab-bevacizumab and delayed transcatheter arterial embolization in advanced hepatocellular carcinoma.

Atezolizumab plus bevacizumab (ATZ/BEV) is an established first-line therapy for advanced hepatocellular carcinoma (HCC); however, complete response (CR) is rare. A man in his 70s was diagnosed with unresectable, multifocal HCC (maximum diameter, 190 mm) with vascular invasion. Liver function was preserved (Child-Pugh A, ALBI grade 1). ATZ/BEV was initiated, but the second cycle was postponed due to adverse events and intratumoral hemorrhage. Eight weeks later, selective transcatheter arterial embolization (TAE) was performed. Follow-up imaging showed disappearance of arterial enhancement in both embolized and non-embolized lesions. The patient has maintained CR for three years without additional treatment following sequential ATZ/BEV and selective TAE.