FOLFOX-HAIC Combined With Donafenib and Pucotenlimab as First-Line Treatment for Unresectable Intrahepatic Cholangiocarcinoma

Inclusion Criteria: * Male or female participants aged 18 to 75 years. * Histologically or clinically diagnosed Hepatocellular Carcinoma (HCC) according to AASLD or EASL guidelines. * Disease stage classified as Barcelona Clinic Liver Cancer (BCLC) stage B (unresectable) or stage C. * No prior systemic treatment for advanced HCC (treatment-naïve). * At least one measurable lesion according to RECIST v1.1 criteria. * Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. * Child-Pugh liver function class A (score 5-6). * Life expectancy of at least 3 months. * Adequate bone marrow function: Absolute neutrophil count (ANC) ≥ 1.5 × 10\^9/L, Platelets ≥ 75 × 10\^9/L, and Hemoglobin ≥ 90 g/L. * Adequate liver function: Total bilirubin ≤ 1.5 × ULN; ALT and AST ≤ 5 × ULN. * Adequate renal function: Serum creatinine ≤ 1.5 × ULN or creatinine clearance ≥ 50 mL/min. * Adequate coagulation function: INR ≤ 1.5 or PT ≤ 1.5 × ULN. * Participants suitable for hepatic artery catheterization and HAIC treatment as assessed by the investigator. * Willingness to provide written informed consent. Exclusion Criteria: * Known hypersensitivity or allergy to Oxaliplatin, Fluorouracil, Leucovorin, Donafenib, Pucotenlimab, or any of their excipients. * Previous treatment with anti-PD-1/PD-L1 antibodies, anti-CTLA-4 antibodies, or other immunomodulatory agents. * Diagnosis of other malignant tumors within the past 5 years (excluding cured basal cell carcinoma of the skin or carcinoma…