Check eligibility

 (for full list see study protocol) 

1. Patient's signed informed consent
2. Age ≥18 years at time of signing Informed      Consent Form
3. Ability to comply with the study protocol,      according to investigator's judgement
4. Life expectancy of at least 12 weeks
5. HCC with histologically confirmed diagnosis
6. Disease that is not amenable to curative surgical and/or local ablation but eligible for TACE
7. ECOG Performance Status of 0 or 1
8. Child-Pugh class A or B7
9. Adequate hematologic and end-organ function
10. Negative HIV test at screening

    (for full list see study protocol) 

1. Diffuse HCC or presence of vascular invasion or extrahepatic spread or more than 7 lesions or at least one lesion >= 7 cm
2. Clinically relevant ascites, history or presence of hepatic encephalopathy
3. Uncontrolled pleural effusion or pericardial effusion
4. Co-infection of HBV and HCV
5. Prior systemic therapy for HCC, prior treatment with TACE or selective internal radiation treatment (SIRT)
6. Any condition representing a contraindication to TACE
7. Major gastrointestinal bleeding within 4 weeks prior to randomization, untreated or incompletely treated varices with bleeding or high-risk for bleeding.
8. Active or history of autoimmune disease or immune deficiency, patients actively listed for transplantation, or prior allogeneic stem cell or solid organ transplantation
9. History of idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitis obliterans), drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography (CT) scan
10. Active tuberculosis
11. Severe infection requiring antibiotics within 4 weeks prior to randomization
12. Significant cardiovascular disease
13. History of congenital long QT syndrome or corrected QT interval >500 ms at screening ECG
14. Inadequately controlled arterial hypertension or prior history of hypertensive crisis or hypertensive encephalopathy
15. Significant vascular disease including aortic aneurysm requiring surgical repair or peripheral arterial thrombosis with 6 months prior to randomization
16. History of abdominal or tracheoesophageal fistula or gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to randomization.
17. History or clinical signs of gastrointestinal obstruction or requirement for routine parenteral hydration, parenteral nutrition, or tube feeding. Evidence of abdominal free air that is not explained by paracentesis or recent surgical procedure
18. History of intra-abdominal inflammatory process within 6 months prior to randomization, including but not limited to peptic ulcer disease, diverticulitis, or colitis
19. Evidence of bleeding diathesis or significant coagulopathy
20. Any other disease, metabolic dysfunction,      physical examination finding, or clinical laboratory finding that      contraindicates the use of an investigational drug, may affect the interpretation      of the results, or may render the patient at high risk from treatment      complications.
21. Uncontrolled tumor-related pain. Patients requiring pain medication must be on a stable regimen at enrollment.
22. Severe, non healing or dehisced wound, active ulcer, or untreated bone fracture
23. History of malignancy other than HCC, with the exception of patients who have been disease-free for at least five years before enrollment or patients with adequately treated and completely      resected basal cell or squamous cell skin cancer, in situ cervical, breast      or prostate cancer, stage I uterine cancer
24. Current or recent (within 10 days prior to randomization) use of full dose oral or parenteral anticoagulants or thrombolytic agents for therapeutic purpose.
25. Treatment with a live, attenuated vaccine      within 4 weeks prior to randomization, or anticipation of need for such a      vaccine during atezolizumab treatment or within 5 months after the last      dose of atezolizumab
26. Prior treatment with CD137 agonists or immune      checkpoint blockade therapies, including anti-CTLA-4, anti-PD-1, and      antiPD-L1 therapeutic antibodies
27. Hypersensitivity to atezolizumab or      bevacizumab or any of the excipients, known hypersensitivity to Chinese      hamster ovary cell products, known hypersensitivity to human or humanized      antibodies
28. Treatment with systemic immunostimulatory      agents (including, but not limited to, interferon and interleukin 2      [IL-2]) within 4 weeks or 5 half-lives of the drug (whichever is longer)      prior to randomization
29. Treatment with systemic immunosuppressive      medication within 2 weeks prior to randomization, or anticipation of need      for systemic immunosuppressive medication during study treatment, with the      following exceptions:
30. Major surgical procedure other than for      diagnosis, open biopsy, or significant traumatic injury within 28 days      prior to randomization, or abdominal surgery, abdominal interventions or      significant abdominal traumatic injury within 60 days prior to      randomization or anticipation of need for major surgical procedure during      the course of the study or non-recovery from side effects of any such      procedure
31. Core biopsy or other minor surgical procedure,      excluding placement of a vascular access device, within 3 days prior to      the first dose of bevacizumab
32. Pregnant or breastfeeding females
33. Participation in a clinical trial or      experimental drug treatment within 28 days prior to inclusion in the      clinical trial or within a period of 5 half-lives of the substances      administered in a clinical trial or during an experimental drug treatment      prior to inclusion in the clinical trial, depending on which period is      longest, or simultaneous participation in another clinical trial while      taking part in this clinical trial.