464 HCC Clinical Trials Recruiting Now (July 2026): Hepatocellular Carcinoma — Atezolizumab + Bevacizumab, Durvalumab + Tremelimumab, ADI-PEG 20, Cadonilimab Adjuvant, Rilvegostomig, TACE, HAIC, TKI

Last updated: July 1, 2026 (post-ASCO 2026)

Current Clinical Trial Landscape

Recruiting Trials by Treatment Setting

Neoadjuvant / Adjuvant (Around Surgery or Transplant)

Immunotherapy before/after resection to reduce recurrence — a rapidly growing area:

• Neoadjuvant:
  • NCT07475026 - Neoadjuvant tislelizumab + lenvatinib in resectable HCC at high recurrence risk (Phase 3)
  • NCT07461675 - Neoadjuvant immunotherapy effects on anti-tumour immunity in HCC (Phase 3)
  • NCT07027436 - RT + durvalumab + tremelimumab + surgery vs surgery alone (Phase 3)
• NCT07417397 — Adjuvant TACE in HCC with high-risk recurrence factors (Phase 3)
• NCT07186621 — Adjuvant RT + sintilimab vs TACE for HCC (Phase 3)

Intermediate Stage — TACE / HAIC Combinations

TACE plus systemic therapy is transforming intermediate HCC treatment after LEAP-012 and EMERALD-1 results; HAIC head-to-head trials are particularly active in China:

• • NCT07594340 — HAIC vs TACE, both combined with sintilimab + bevacizumab, for intermediate HCC beyond up-to-seven criteria (Phase 3, newly opened)
  • NCT06371157 — Cadonilimab (AK104) + lenvatinib + TACE vs TACE in intermediate-stage HCC (Phase 3)
  • NCT06485466 — TACE + camrelizumab + apatinib for unresectable HCC (Phase 3)
  • NCT07309419 — TACE + oral triple-agent cocktail vs TACE + placebo (Phase 3)
  • NCT07302919 — TACE + ABCB1 inhibition vs TACE alone (Phase 3)
  • NCT07322848 — DEB-TACE vs cTACE in HCC after TIPS (Phase 3)

Advanced / Metastatic — First-Line

Immunotherapy combinations are standard (IMbrave150 atezolizumab + bevacizumab; HIMALAYA durvalumab + tremelimumab STRIDE). Trials test bispecific checkpoint + anti-VEGF, new IO combos, HAIC additions, and metabolic novel agents:

• IO combinations:
  • NCT06921785 — Rilvegostomig (AZD2936) (PD-1/TIGIT bispecific, AstraZeneca) + bevacizumab ± tremelimumab vs atezolizumab + bevacizumab as 1L (ARTEMIDE-HCC01, Phase 3 3-arm). The PD-1/TIGIT bispecific head-to-head against the IMbrave150 standard.
  • NCT07490262 — IBI310 (anti-CTLA-4) + sintilimab (anti-PD-1) combination for advanced HCC (Phase 3)
  • NCT06680258 — TPST-1120 (PPARα antagonist) + atezolizumab + bevacizumab (Phase 3)
• HAIC + systemic therapy:
  • NCT07267806 — Camrelizumab + apatinib ± FOLFOX chemotherapy (Phase 3)
  • NCT06172205 — FOLFOX + camrelizumab + apatinib vs HAIC-FOLFOX + camrelizumab + apatinib (Phase 3)
  • NCT06904170 — Durvalumab + tremelimumab ± HAIC (Phase 3)
• Biomarker-enriched metabolic targets:
  • NCT05317819 — ADI-PEG 20 (pegargiminase) vs placebo in unresectable HCC with elevated baseline serum arginine (Phase 3, biomarker-enrichment). PEGylated arginine deiminase from Polaris Pharmaceuticals; depletes circulating arginine to selectively starve arginine-auxotroph tumors (typically ASS1-deficient). The most clinically advanced ongoing arginine-depletion oncology trial.

Advanced — Second-Line and Beyond

After first-line IO failure, options include TKIs and novel agents:

• • NCT07392866 — SH006 + combination therapy vs regorafenib (Phase 3)
  • NCT06109272 — Livmoniplimab (anti-GARP:TGF-β1) + budigalimab (anti-PD-1) vs atezolizumab + bevacizumab (Phase 3)

Etiology-Defined Cohorts (MASLD / MASH, HBV, HCV)

HCC arising from metabolic-associated steatotic liver disease (MASLD, formerly NAFLD / NASH) may respond differently to immunotherapy than HBV- or HCV-driven HCC — a hypothesis driving dedicated etiology cohorts:

• • NCT07285850 — Sequential vs concurrent bevacizumab + atezolizumab in advanced HCC arising in the context of MASLD (Phase 2/3, MASLD-cohort-specific)

Locoregional Approaches (Y-90 / SBRT / Ablation)

SBRT, Y-90 (yttrium-90) radioembolization / SIRT, and ablation — often combined with systemic therapy:

• • NCT07293468 — SBRT vs SIRT (Y-90 selective internal radiation therapy) + combination IO for unresectable HCC (BIIRTH, Phase 3)
  • NCT07166406 — Immunotherapy ± SBRT in HCC (Phase 3)
  • NCT07381660 — SBRT vs surgical resection for small HCC (Phase 3)

Biomarkers & Molecular Subtypes That Affect HCC Trial Eligibility

HCC is increasingly stratified by biomarkers that affect IO response, eligibility, and which trials match. Bring these results from your oncologist if you have them — they make matching faster:

• AFP (alpha-fetoprotein): Standard serum marker. AFP ≥400 ng/mL is the entry criterion for ramucirumab (2L). Several trials stratify or enrich by AFP level.
• Serum arginine: The ADI-PEG 20 (pegargiminase) Phase 3 (NCT05317819) uses an elevated-baseline-arginine threshold as a biomarker-enrichment criterion, on the hypothesis that patients with higher reservoir arginine derive greater benefit from arginine depletion.
• PD-L1 expression: Less central in HCC than in NSCLC, but informs IO trial design and sub-group analyses. Atezolizumab + bevacizumab and durvalumab + tremelimumab work across PD-L1 levels in 1L HCC.
• β-catenin / CTNNB1 mutations: Activating CTNNB1 (Wnt/β-catenin pathway) mutations are associated with a "cold" immune-excluded tumor microenvironment and may predict relative resistance to checkpoint inhibition. Some trials enrich for or stratify by CTNNB1 status; non-IO approaches (e.g., metabolic / anti-angiogenic) may be a better fit when CTNNB1-mutant.
• Etiology (HBV, HCV, MASLD/MASH, alcohol): Underlying liver disease affects both eligibility (e.g., HBV reactivation prophylaxis required for IO) and possibly biology. NCT07285850 is a dedicated MASLD-cohort Phase 2/3.
• Child-Pugh score: Most pivotal trials require Child-Pugh A (preserved liver function). Child-Pugh B7 patients have fewer options — NCT05201404 (namodenoson) targets this under-served group.
• BCLC stage: A vs B vs C drives whether resection, transplant, locoregional (TACE / Y-90), or systemic therapy is the appropriate trial setting.
• Vascular invasion / extrahepatic spread: Defines BCLC C and shapes whether locoregional, systemic, or combined approaches are eligible.

Prevention

• • NCT07529262 - AspiRe HCC: Aspirin to reduce HCC risk in cirrhosis (Phase 3)

Showing selected notable trials. View all 464 recruiting interventional trials on ClinicalTrials.gov.

Frequently Asked Questions