Study of Cabozantinib in Combination With Atezolizumab Versus Sorafenib in Participants With Advanced Hepatocellular Carcinoma (HCC) Who Have Not Received Previous Systemic Anticancer Therapy

This study is designed for adults with advanced liver cancer (hepatocellular carcinoma) that has been diagnosed by medical tests. Your cancer shouldn't be treatable by surgery, transplant, or other local treatments. You must also not have had any previous drug treatments for your advanced liver cancer.

There are also some specific medical requirements, such as how well your liver is working and your general health. For example, your liver function needs to be good enough, and you should be generally active. Your cancer also needs to be measurable, meaning doctors can see and track its size.

However, you cannot join if you have a different rare type of liver cancer, or if your cancer has spread to your brain unless it's been successfully treated and stable for several weeks. You also can't be on certain blood thinners or have had recent radiation therapy.

If you decide to join this study, you will first go through an initial screening to ensure you meet all the requirements. If you do, you'll be assigned randomly to one of three groups: one group will receive a combination of cabozantinib and atezolizumab, another will receive sorafenib, and a third will receive only cabozantinib. You won't be able to choose which group you are in, and neither you nor your doctor will know which treatment you are receiving (this is called 'open-label' for the first two groups, but you'll know if you're in the cabozantinib-only arm).

Both drugs are taken orally, likely as tablets or capsules, and atezolizumab is given as an infusion. You'll have regular visits to the clinic for medical check-ups, blood tests, and scans (like CT or MRI) to see how you're responding to the treatment and to monitor for any side effects. The treatment will continue for as long as it's helping and you're not having serious side effects. After treatment stops, there will be follow-up appointments to track your health and gather more information, which could last for several months or longer.