Abstract: Objective To investigate the efficacy of bevacizumab combined with programmed death receptor-1 (PD-1) / programmed death ligand 1 (PD-L1) inhibitors in the treatment of primary liver cancer (HCC) patients.Methods From June 2020 to February 2024, 80 cases of HCC were enrolled in our hospital. A control group (40 cases) and an observation group (40 cases) were randomly assigned according to a random number table. The patients in control group were treated by PD-1/PD-L1 inhibitor, and the patients in observation group were treated by PD-1/PD-L1 inhibitor and bevacizumab. The clinical efficacy, levels of alpha fetoprotein (AFP), alanine aminotransferase (ALT), vascular endothelial growth factor (VEGF), aspartate aminotransferase (AST), carbohydrate antigen 199 (CA199), albumin (ALB), and safety were compared between two groups.Results The results showed that the therapeutic effect was better in the observation group (95.00%) than that in the control group (75.00%) (P<0.05). After treatment, the observation group had lower levels in VEGF[(85.38 ± 7.26) pg/mL], AFP [(89.62 ± 7.65) ng/mL], and CA199 [(47.13 ± 9.66) U/mL] when compared with the control group [(102.21 ± 10.34) pg/mL (VEGF), (108.35 ± 10.76) ng/mL (AFP), (58.61 ± 10.12) U/mL (CA199)], (P<0.05). The observation group showed a better improvement in the levels of AST [(50.39 ± 5.11) U/L], ALT [(30.57 ± 3.26) U/L], and ALB [(44.26 ± 4.01) g/L] when compared to the control group [(55.32 ± 5.26) U/L, (35.45 ± 3.24) U/L, and (39.42 ± 3.86) g/L) (P<0.05)]. The safety of the two groups was comparable (P>0.05).Conclusion The combination of bevacizumab and PD-1/PD-L1 inhibitors can reduce the levels of relevant serum tumor markers in patients with primary liver cancer, and improve the liver function with a great safety.

Key words: Bevacizumab monoclonal antibody, PD-1/PD-L1 inhibitors, Primary liver cancer, Xindilimumab