With China’s growing population and increased awareness of cancer prevention, the incidence and detection rates of liver cancer have risen significantly. Primary liver cancer ranks fifth in incidence and second in mortality in China, and its prognosis is generally poor. Most patients with intermediate-to-advanced liver cancer are ineligible for curative treatment, making systemic therapy critical.The Chinese Guidelines for the Diagnosis and Treatment of Primary Liver Cancer (2024 Edition) recommend the combination of atezolizumab and bevacizumab as the first-line treatment regimen for patients with unresectable liver cancer who have not previously received systemic therapy.This study reports on the outcomes of 53 patients with mid-to-late-stage liver cancer who received this combination therapy at our hospital between August 2024 and February 2026. During treatment, patients experienced adverse reactions such as hypertension, hypoalbuminemia, abdominal distension, fatigue, gastrointestinal bleeding, and anaphylactic shock; all recovered and were discharged after receiving standardized treatment and nursing care.Throughout the nursing process, emphasis was placed on pre-medication assessment and patient education, medication preparation and infusion care, monitoring of clinical status and adverse reactions, as well as patient health education and psychological care. The study highlights that while combination therapy can prolong patient survival, managing adverse reactions is challenging, placing higher demands on nursing staff, who must possess a comprehensive knowledge base and proficient professional skills.

Qiu Wenting, Yu Lanfang. Nursing Care for 53 Patients with Advanced Hepatocellular Carcinoma Treated with Atezolizumab Combined with Bevacizumab. International Journal of Frontiers in Medicine (2026), Vol. 8, Issue 1: 97-102. https://doi.org/10.25236/IJFM.2026.080113.

[1] HAN B F, ZHENG R S, ZENG H M, et al. Cancer incidence and mortality in China, 2022 [J]. Journal of the National Cancer Center, 2024, 4(1):47-53. 

[2] Department of Medical Administration, National Health Commission of the People’s Republic of China. Guidelines for the Diagnosis and Treatment of Primary Liver Cancer (2024 Edition) [J]. Journal of Peking Union Medical College, 2024, 15(3):532-558. 

[3] Lang Xu, Liu Boyu, Zeng Jia. A Comparative Study on the Efficacy and Safety of Atezolizumab Combined with Bevacizumab Versus Lenvatinib in HBV-Associated Unresectable Hepatocellular Carcinoma [J]. Chinese Medical Journal, 2026, 106(6):559-565. 

[4] SHOMURA M, OKABE H, SAKAKIBARA M, et al. Impact of Atezolizumab + Bevacizumab Therapy on Health-Related Quality of Life in Patients with Advanced Hepatocellular Carcinoma[J]. Cancers, 2024, 16(21):3610. 

[5] HSU C, RIMASSA L, SUN H C, et al. Immunotherapy in hepatocellular carcinoma: evaluation and management of adverse events associated with atezolizumab plus bevacizumab[J]. Therapeutic Advances in Medical Oncology, 2021, 13: 17588359211031141.

[6] Li Xuerui, Li Junfeng, Zhang Wenwen, et al. Long-term efficacy of an immunotherapy-targeted therapy combination followed by radical surgical resection for the treatment of initially unresectable hepatocellular carcinoma [J]. Chinese Journal of Hepatobiliary Surgery, 2024, 30(1): 9-14. 

[7] Yu Feihong, Xiong Shunyu, Li Jiazhao, et al. Systematic review and re-evaluation of the efficacy and safety of atezolizumab in the treatment of hepatocellular carcinoma [J]. Chinese Journal of Hospital Pharmacy, 2024, 44(12): 1442-1447. 

[8] Chinese Nursing Association. Intravenous Administration Techniques for Anticancer Drugs: T/CNAS 53-2025 [S]. Beijing: China Standards Press, 2025. 

[9] Oncology Nursing Professional Committee of the Chinese Nursing Association, Oncology Nursing Professional Committee of the Shanghai Anti-Cancer Association, Yang Zhan, et al. Expert Consensus on Patient Self-Management of Skin Adverse Reactions Associated with Targeted Anticancer Drug Therapy [J]. Chinese Journal of Nursing, 2024, 59(17): 2095-2099. 

[10] Sun Yu, Li Yangyang, Li Zhenli, et al. Current Status and Prospects of Adjuvant Therapy Following Curative Resection for Hepatocellular Carcinoma [J]. Chinese Journal of Experimental Surgery, 2025, 42(6): 1152-1156. 

[11] Guangdong Nursing Association. Identification and Nursing of Adverse Reactions in Immune Checkpoint Inhibitor Therapy for Cancer Patients: T/GDNAS 055—2024[S]. 2024.

[12] Cheng Jieyin, Liu Ruijuan, Chen Jinjiao. Application of Rational Emotive Therapy Combined with Evidence-Based Preventive Nursing in Cancer Patients Receiving Targeted and Immunotherapy Combination Therapy [J]. Qilu Nursing Journal, 2021, 27(11): 27-29. 

[13] Liu Shuhui, Pan Ruili. Roles and Functions of Oncology Nurse Specialists in Immunotherapy in China [J]. Chinese Journal of Modern Nursing, 2021, 27(15): 2087-2091. 

[14] Jiang Kai, Yan Rong, Meng Xiangmin, et al. Development of a Specialized Training Program for Oncology Nurses in Immunotherapy [J]. Chinese Journal of Practical Nursing, 2024, 40(29): 2292-2299. 

[15] Yong Dingli, Gu Aihua, Chen Xiaofang. Experience in Emergency Management and Medication Care for a Case of Anaphylactic Shock Induced by Atezolizumab [J]. Contemporary Nurse (Late Edition), 2022, 29(10):143-147. 

[16] Specialized Committee on Rehabilitation of Allergic Diseases, Chinese Society of Rehabilitation Medicine; Allergen-Specific Diagnosis Working Group, Allergy Branch, Chinese Medical Association; Specialized Committee on Prevention and Control of Allergic Diseases, Chinese Preventive Medicine Association; et al. Expert Consensus on the Diagnosis and Clinical Management of Severe Allergic Reactions [J]. Chinese Journal of Preventive Medicine, 2025, 59(6): 749-765. 

[17] Zhang Ziwei, Luo Bing, Ge Weihong, et al. Interpretation and Evidence Analysis of the EAACI and WAO Guidelines on Pharmacological Emergency Management of Anaphylaxis [J]. Medical Guide, 2021, 40(11):1511-1516.