[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100656517":3},{"organization":4,"outcomesModule":7,"designInfo":26,"detailedDescription":16,"studyPopulation":29,"armGroups":30,"interventions":16,"overallOfficials":16,"centralContacts":39,"locations":45,"responsibleParty":64,"collaborators":16,"id":67,"slug":68,"hasResults":69,"nctId":70,"briefTitle":71,"officialTitle":72,"acronym":16,"eligibilityCriteria":73,"healthyVolunteers":69,"sex":74,"minAge":75,"maxAge":16,"enrollmentInfo":76,"targetDuration":79,"studyType":80,"phases":16,"briefSummary":81,"conditions":82,"keywords":16,"overallStatus":84,"whyStopped":16,"lastUpdateSubmitDate":85,"lastUpdatePostDateStruct":86,"startDateStruct":89,"completionDateStruct":91,"leadSponsor":93,"locationsCount":94},{"fullName":5,"class":6},"Zhongda Hospital","OTHER",{"primaryOutcomes":8,"secondaryOutcomes":13,"otherOutcomes":22},[9],{"measure":10,"description":11,"timeFrame":12},"Overall survival","With OS as the primary outcome, to estimate the overall treatment effect and CATE of initiating LRTs within 60 days after Atezo+Bev initiation versus not initiating LRTs within 60 days; and to integrate baseline clinical variables with multiregional radiomic, dynamic\u002Fhabitat, and deep representation features from pretreatment contrast-enhanced CT\u002FMRI to develop and validate an HTE decision model.","through study completion, an average of 1 year",[14,17,19],{"measure":15,"description":16,"timeFrame":12},"Model calibration",null,{"measure":18,"description":16,"timeFrame":12},"Benefit ranking",{"measure":20,"description":21,"timeFrame":12},"PFS\u002FmPFS","Defined as the time from index date to the first occurrence of disease progression or death from any cause (whichever occurs first), as determined by the investigator according to RECIST v1.1 or mRECIST.",[23],{"measure":24,"description":25,"timeFrame":12},"Adverse event","To describe and compare the spectrum and severity of AEs between the two strategies and within their subgroups, with particular attention to hemorrhage, hypertension, hepatotoxicity, immune-related AEs, and complications associated with each type of LRT.",{"allocation":16,"interventionModel":16,"interventionModelDescription":16,"primaryPurpose":16,"observationalModel":27,"timePerspective":28,"maskingInfo":16},"COHORT","PROSPECTIVE","Adults with uHCC who initiate first-line Atezo+Bev and have received no prior systemic therapy for HCC.",[31,33,35,37],{"label":32,"type":16,"description":16,"interventionNames":16},"Training Cohort",{"label":34,"type":16,"description":16,"interventionNames":16},"Retrospective validation cohort",{"label":36,"type":16,"description":16,"interventionNames":16},"Prospective validation cohort",{"label":38,"type":16,"description":16,"interventionNames":16},"Biological validation cohort",[40],{"name":41,"role":42,"phone":43,"phoneExt":16,"email":44},"Jian Lu","CONTACT","13616106021","lujian43307131@126.com",[46],{"facility":47,"status":16,"city":48,"state":49,"zip":50,"country":51,"countryCode":52,"cosmosGeoPoint":53,"geoPoint":58,"contacts":59},"Zhongda hospital","Nanjing","Jiangsu","213003","China","CN",{"type":54,"coordinates":55},"Point",[56,57],118.77778,32.06167,{"lat":57,"lon":56},[60],{"name":61,"role":42,"phone":62,"phoneExt":16,"email":63},"Jun-Hao Mei","15052007938","jh_mei240225@126.com",{"type":65,"investigatorFullName":41,"investigatorTitle":66,"investigatorAffiliation":5,"oldNameTitle":16,"oldOrganization":16},"PRINCIPAL_INVESTIGATOR","Prof.","100656517","heterogeneity-of-treatment-effects-of-adding-locoregional-therapies-to-atezolizumab-plus-bevacizumab-in-patients-with-unresectable-hepatocellular-carcinoma-ismio-026-100656517",false,"NCT07824765","Heterogeneity of Treatment Effects of Adding Locoregional Therapies to Atezolizumab Plus Bevacizumab in Patients With Unresectable Hepatocellular Carcinoma (ISMIO-026)","Heterogeneity of Treatment Effects of Adding Locoregional Therapies to Atezolizumab Plus Bevacizumab in Patients With Unresectable Hepatocellular Carcinoma Based on Clinical and Multiregional, Multiphase Contrast-Enhanced CT\u002FMRI Features (ISMIO-026)","Inclusion Criteria:\n\n* Age ≥18 years on the index date.\n* Receipt of at least one dose each of atezolizumab and bevacizumab as part of the same first-line combination regimen, with an interval of ≤28 days between the first administrations of the two drugs.\n* At least one intrahepatic lesion amenable to a protocol-specified LRT on the index date, with no absolute contraindication to Atezo+Bev or to all feasible LRTs.\n* A clinical, radiologic, or pathologic diagnosis of uHCC on or before the index date; baseline EHS is permitted.\n* Survival status or the date last known alive after the index date can be ascertained.\n* No systemic therapy for HCC before the regimen initiation date.\n* No LRT within 60 days before the index date or between baseline imaging and the index date; earlier prior LRTs are permitted provided that an untreated, measurable intrahepatic lesion remains.\n* A technically adequate baseline contrast-enhanced CT\u002FMRI examination and at least one untreated intrahepatic lesion that can be delineated and evaluated.\n* Baseline ECOG performance status of 0-2.\n\nExclusion Criteria:\n\n* Another primary malignancy requiring active systemic treatment on the index date, except for a malignancy that has been cured and has a low risk of recurrence.\n* Participation on the index date in an interventional study that could affect treatment allocation or outcome assessment.\n* Suitability for immediate curative resection or liver transplantation following multidisciplinary assessment.\n* An absolute contraindication to Atezo+Bev or to all feasible LRTs.\n* Active autoimmune disease or immunodeficiency requiring systemic immunosuppression or constituting a contraindication to atezolizumab.\n\nInadequately controlled high-risk esophageal\u002Fgastric varices, recent variceal bleeding, an uncorrected bleeding tendency, or clinically significant coagulopathy.\n\n* Inability to determine the index date, primary treatment strategy, OS outcome\u002Fcensoring date, or absence of a technically adequate baseline contrast-enhanced CT\u002FMRI examination.","ALL","18 Years",{"count":77,"type":78},2658,"ESTIMATED","36 Months","OBSERVATIONAL","uHCC imposes a substantial disease burden in China and the Asia-Pacific region. Atezo+Bev is an important first-line regimen for patients who have not received prior systemic therapy; however, not all patients achieve adequate and durable tumor control. In clinical practice, ablation, radiotherapy, or transarterial therapy is often added to Atezo+Bev to intensify intrahepatic disease control. The indications, timing, efficacy, and risk of liver-function impairment vary across LRTs. Most existing studies report average treatment effects and often use TACE as a fixed backbone, and therefore do not directly identify which patients receiving Atezo+Bev should receive early LRTs.\n\nUsing target trial emulation and HTE analysis, this study will integrate baseline clinical variables with pretreatment contrast-enhanced CT\u002FMRI features to estimate the CATE of early LRT initiation and identify patients likely to achieve greater survival benefit.",[83],"Unresectable Hepatocellular Carcinoma","NOT_YET_RECRUITING","2026-09-11",{"date":87,"type":88},"2026-09-17","ACTUAL",{"date":90,"type":78},"2026-09-01",{"date":92,"type":78},"2027-12-31",{"name":5,"class":6},1]