Second-line treatment options after lenvatinib (LEN) for patients with advanced hepatocellular carcinoma (HCC) are still limited. We investigated the efficacy and safety of atezolizumab plus bevacizumab (ATZ-BEV) treatment as a second-line treatment after LEN. Twenty patients were included for analysis. The median age of the patients was 71 years, and 18 patients were male. Nineteen patients exceeded up to seven criteria, five patients had tumor thrombosis, and eight patients had metastasis. We observed 50 cases of side-effects evaluated using the Common Terminology Criteria for Adverse Events grading system. Among them, 38 cases were grade 1 or grade 2. One case died of severe liver injury. The response rate was 20%, and the disease control rate was 75% (RECIST version 1.1). ATZ-BEV treatment could be used as a second-line treatment after LEN failure.
