A Study of BL-B01D1 Monotherapy, BL-B01D1 in Combination With Lenvatinib, BL-B01D1 in Combination With PD-1 Monoclonal Antibody, and BL-B01D1 in Combination With PD-1 Monoclonal Antibody and Bevacizumab in Patients With Advanced Hepatocellular Carcinoma

Inclusion criteria

• Sign the informed consent form voluntarily and follow the protocol requirements;
• Gender is not limited;
• Age ≥18 years old and ≤75 years old;
• Expected survival time ≥3 months;
• Patients with advanced HCC confirmed by histology or cytology;
• Consent to provide archived tumor tissue samples or fresh tissue samples from the primary or metastatic lesions;
• At least one measurable lesion meeting the RECIST v1.1 definition was required;
• ECOG score was 0-1;
• The toxicity of previous antineoplastic therapy has returned to ≤ grade 1 as defined by NCI-CTCAE v5.0;
• No severe cardiac dysfunction, left ventricular ejection fraction ≥50%;
• Organ function level must meet the requirements;
• Coagulation function: international normalized ratio (INR) ≤1.5×ULN, and activated partial thromboplastin time (APTT) ≤1.5×ULN;
• Urinary protein ≤2+ or ≤1000mg/24h;
• No cirrhosis or only Child-Pugh A cirrhosis;
• If hepatitis B virus infection is negative or positive, the status of HBV surface antigen (HBsAg) should be confirmed by HBV serological test;
• For premenopausal women of childbearing potential, a pregnancy test must be performed within 7 days before the start of treatment, a serum or urine pregnancy test must be negative, and the patient must not be lactating; All enrolled patients should take adequate barrier contraception during the entire treatment cycle and for 6 months after the end of treatment.

Exclusion criteria

• Patients with active central nervous system metastases;
• Who had participated in any other clinical trial within 4 weeks before the trial dose;
• Received anti-tumor therapy such as chemotherapy, radiotherapy and biological therapy within 4 weeks before the first use of study drug;
• Had undergone major surgery (investigator-defined) within 4 weeks before the first dose;
• Systemic corticosteroids or immunosuppressive therapy is required within 2 weeks before study dosing;
• Pulmonary disease defined as ≥ grade 3 according to NCI-CTCAE v5.0; A history of ILD/pulmonary inflammation requiring steroid treatment;
• Serious systemic infection within 4 weeks before screening;
• Patients at risk for active autoimmune disease or with a history of autoimmune disease;
• Other malignant tumors within 5 years before the first treatment;
• Human immunodeficiency virus antibody positive, active tuberculosis or hepatitis C virus infection;
• Poorly controlled hypertension by two antihypertensive drugs with different mechanisms;
• Diabetic patients with poor glycemic control;
• Had a history of severe cardiovascular and cerebrovascular diseases;
• Previous history of autologous or allogeneic stem cell, bone marrow or organ transplantation;
• Subjects with clinically significant bleeding or significant bleeding tendency within the previous 4 weeks were screened;
• Patients with massive or symptomatic effusions or poorly controlled effusions;
• Imaging examination showed that the tumor had invaded or wrapped around the chest, neck, pharynx and other large arteries or invaded the pericardium and heart;
• Unstable thrombotic events requiring therapeutic intervention within 6 months before screening;
• Prior treatment with an ADC drug with a topoisomerase I inhibitor as a toxin;
• Patients with a history of allergy to recombinant humanized antibodies or to any excipients of the trial drug;
• The cumulative dose of anthracyclines > 360 mg/m2 in previous (new) adjuvant therapy;
• Pregnant or lactating women;
• Who have a history of psychotropic drug abuse and cannot quit or have mental disorders;
• Other conditions for trial participation were not considered appropriate by the investigator.