Evaluation of Efficacy and Safety of Immune Check Point Inhibitors in Hepatocellular Carcinoma Patients in Ain Shams University Hospitals

Inclusion Criteria: * Age ≥ 18. * Hepatocellular carcinoma based on histological diagnosis or the typical findings on radiological imaging including enhanced dynamic computed tomography (CT) and/or dynamic magnetic resonance imaging (MRI). * ECOG Performance status of 0 or 1 * Patients with Child-Pugh class A * BCLC stage B with diffuse, infiltrative, or extensive bilobar involvement * BCLC stage B with tumor progression after failure of TACE * BCLC stage C * No prior systemic therapy for HCC * Additional eligibility criteria; Hb ≥ 9 g/dl, platelets ≥ 75x10%/1, ANC ≥ 1.5 x10% for Atezolizumab/bevacizumab and ANC ≥ 1x10%1 for Durvalumab/Tremilimumab, INR ≤ 2, albumin ≥ 2.8 g/dl, total bilirubin ≤ 3 mg/dl, AST and ALT ≤ 5 x ULN, creatinine clearance ≥ 50 ml/min * Additional criteria for Atezolizumab/Bevacizumab; upper endoscopy showing no risky high grade esophageal varices (within 6 months of first dose) unless adequately managed Exclusion Criteria: * Performance status ≥ 2 * Patients with Child-Pugh class B or C * BCLC stage A or D * Active tuberculosis or active human immunodeficiency virus (HIV) infection * HCV or HBV infection except if; HBV DNA \< 500 IU/ml or started anti- HBV treatment for a minimum of 14 days prior to first dose * Severe infection requiring hospitalization within 4 weeks prior to first dose * History of allogenic stem cell or solid organ transplant * Treatment with systemic immunostimulatory or immunosuppressive medication * Active and history of…