Fecal Microbiota Transplantation Combined With QL1706 Plus Bevacizumab for Advanced HCC

This is a prospective, single-center, single-arm Phase II pilot study designed to evaluate the efficacy and safety of FMT in combination with QL1706 and Bevacizumab as first-line treatment for advanced Hepatocellular carcinoma.

Inclusion Criteria: * Age \>18 years. * Confirmed imaging or histological diagnosis of unresectable HCC. * Treatment-naïve unresectable or metastatic HCC. * BCLC Stage C. * Child-Pugh A. * ECOG PS 0-1. Exclusion Criteria: * Prior treatment with an immune checkpoint inhibitor, or prior systemic therapy for advanced HCC. * Histologic subtypes other than hepatocellular carcinoma, including fibrolamellar HCC, sarcomatoid HCC, and mixed hepatocellular cholangiocarcinoma. * Active or prior autoimmune disease, immunodeficiency requiring systemic immunosuppressive therapy. * Clinically significant bleeding risk, coagulopathy, or untreated high-risk esophagogastric varices. * Any contraindication to fecal microbiota transplantation. * Uncontrolled intercurrent illness, including active infection, clinically significant cardiovascular disease, central nervous system metastases. * Pregnancy or breastfeeding.