A Study of Atezolizumab and Bevacizumab in Hepatocellular Carcinoma

Inclusion Criteria: Subject must meet all of the following applicable inclusion criteria to participate in this study: * Written informed consent and HIPAA authorization for release of personal health information must be obtained either from the subject or their representative. See protocol. NOTE: HIPAA authorization may be included in the informed consent or obtained separately. * Age ≥ 18 years at the time of consent. * ECOG Performance Status of 0-1. * Locally advanced, metastatic, or unresectable hepatocellular carcinoma that has not received prior systemic therapy. Note: if no prior histologic diagnosis exists, prefer fresh biopsy if it is both safe and feasible. If fresh biopsy is not safe and feasible, imaging criteria may be used for diagnosis as per AASLD criteria in cirrhotic patients (please see www.aasld.org for up to date guidelines). * Child Pugh Class B7 or B8 liver dysfunction or cirrhosis with the following limitations: * Bilirubin ≤ 3 mg/dL * Albumin ≥ 2.8 g/dL * INR ≤ 1.7 * Absent to slight \[CP=1 to 2\] (no moderate \[CP=3\]) ascites (Also see exclusion criteria). * No clinically significant encephalopathy (Also see exclusion criteria). * At least 1 untreated measurable lesion according to RECIST 1.1. * Willingness to undergo fresh tumor biopsy at baseline if safe and feasible. Note: archival tissue may be used at baseline provided histologic diagnosis was made and sufficient tissue is available for NGS analysis. * NGS analysis must be request…