Evaluating the Effectiveness of Proton Beam Radiotherapy Combined with Atezolizumab and Bevacizumab for Primary Liver Cancer with Portal Vein Invasion: The PORTAL Study

Hepatocellular carcinoma (HCC), or liver cancer, occurs when a tumor (an abnormal mass of tissue that forms when cells grow and divide more than they should or do not die when they should) grows on the liver. It is one of the most common cancers and the second leading cause of cancer-related deaths worldwide. Treatment options depend on how far the disease has progressed. In advanced cases, patients are usually treated with anti-cancer drugs. One major study, called IMbrave150, showed that a combination of two medicines—Atezolizumab and Bevacizumab—helped patients with advanced liver cancer live longer. Atezolizumab helps the immune system attack cancer cells, while Bevacizumab blocks the growth of new blood vessels that tumors need to grow.

Radiation therapy (a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors) is another treatment option for liver cancer. However, most radiation therapy uses “photon” beams (a type of high-energy X-ray to target the tumor), which can harm healthy liver tissue in patients who already have poor liver function. Proton beam therapy, which uses “proton" (tiny particles that carry a positive charge) instead of photon, is a different approach that can better protect healthy areas by more precisely targeting the tumor.

This study aims to find out whether adding proton beam therapy to Atezolizumab and Bevacizumab can help patients with advanced liver cancer that has spread to major blood vessels in the liver live longer and control the disease more effectively.