For over a decade, sorafenib remained the only systemic agent with proven 
clinical efficacy for patients with advanced hepatocellular carcinoma (HCC). 
Recent years have seen a proliferation of agents. In the first line, lenvatinib 
was found to be non-inferior to sorafenib in terms of overall survival (OS), 
with significantly better progression-free survival and objective response rate. 
Meanwhile, encouraging efficacy signals were observed in phase I/II studies of 
immune checkpoint inhibitors as monotherapy in HCC. Although subsequent phase 
III trials failed to demonstrate statistically significant benefit in OS, other 
clinically meaningful outcomes were observed, including long-term disease 
control with a favorable toxicity profile. In addition, a synergistic response 
has been postulated based on the interplay between antiangiogenic molecular 
targeted agents and immunotherapy. On this basis, interest has turned toward 
combination strategies of immunotherapy with these standard-of-care medications 
in the hope of improving treatment efficacy for advanced HCC, while maintaining 
tolerable safety profiles. Indeed, preliminary results from phase I studies of 
lenvatinib plus pembrolizumab and atezolizumab plus bevacizumab have proved 
favorable, prompting phase III investigations in the frontline setting, and for 
atezolizumab plus bevacizumab, these positive findings have been substantiated 
by recent reporting of phase III data from IMbrave150. In this review, we will 
present the currently available data on combination therapy atezolizumab plus 
bevacizumab in advanced HCC, and compare these findings to other promising 
combination treatments, most notably that of lenvatinib plus pembrolizumab.