Fecal Microbiota Transfer in Liver Cancer to Overcome Resistance to Atezolizumab/Bevacizumab (FLORA)

This study (FLORA) tests whether a fecal microbiota transplant (FMT) — transferring gut bacteria from a healthy donor — can help people with advanced liver cancer (hepatocellular carcinoma, or HCC) respond better to a standard immunotherapy combination (atezolizumab and bevacizumab). **You may be eligible if...** - You are 18 or older - You have confirmed liver cancer (HCC) that cannot be surgically removed, transplanted, or treated locally - You are eligible for the standard immunotherapy combination (atezolizumab and bevacizumab) - Your liver function is preserved (Child-Pugh A or early B) - You have measurable disease on scans - You are in good general health (ECOG 0–1) **You may NOT be eligible if...** - You have taken immunosuppressive drugs in the past 6 months - You have an active autoimmune or inflammatory condition - You have previously received immune checkpoint therapy (like anti-PD-1 or anti-CTLA-4) - You are HIV positive - You have both hepatitis B and hepatitis C infections - You have uncontrolled high blood pressure or varicose veins in the esophagus at risk of bleeding Talk to your doctor to see if this trial is right for you.