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Yttrium-90 + atezolizumab + bevacizumab is an investigational combination regimen being studied for the treatment of advanced unresectable hepatocellular carcinoma (HCC). The regimen integrates three distinct therapeutic modalities: (1) **Yttrium-90 (Y-90)**, a radioactive isotope delivered via glass microspheres (TheraSphere) through transarterial radioembolization (TARE), which provides targeted internal radiation to liver tumors; (2) **atezolizumab**, a humanized monoclonal antibody that inhibits Programmed Death-Ligand 1 (PD-L1), thereby restoring anti-tumor T-cell activity; and (3) **bevacizumab**, a monoclonal antibody targeting Vascular Endothelial Growth Factor (VEGF) to inhibit tumor angiogenesis and potentially normalize the tumor vasculature to enhance immune cell infiltration. This combination leverages the synergistic potential of localized radiotherapy and systemic dual-pathway immunotherapy (PD-L1 and VEGF inhibition), a strategy aimed at improving outcomes in patients with high-risk HCC.
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