Chronic hepatitis B is a major cause of liver cancer worldwide, especially in Asia, and while current antiviral medications can control the virus and lower cancer risk, they rarely eliminate it completely, meaning patients often need lifelong treatment and still face ongoing liver damage.

This study is being done because new immune-based treatments may help the body clear the virus more effectively: standard drugs suppress the virus but can take decades to reduce key viral markers, whereas early research suggests immune checkpoint therapy may speed up this process by strengthening the body’s own immune response.

By comparing immune therapy with standard targeted treatments in patients with advanced liver cancer and hepatitis B, researchers aim to see whether immune therapy can reduce the virus more quickly, potentially shortening treatment duration and improving long-term liver health.

Participants will take part in the study over a period of up to 2 years, following a structured timeline designed to closely monitor treatment effects and safety.

Screening (before treatment starts):

• Blood tests, CT or MRI scans, and medical history review to confirm eligibility.

Treatment period (up to 2 years):

• Immune checkpoint therapy group: Durvalumab given by intravenous infusion every 4 weeks.
• Targeted therapy group: Daily oral targeted cancer medication, prescribed by participant's personal doctor.

Regular follow-up visits:

• Throughout treatment, participants will have scheduled clinic visits for blood tests (including hepatitis B markers), imaging scans to assess the tumour, and discussions about the health condition in general.

Safety monitoring:

• Participants are continuously monitored for side effects and overall treatment tolerance from the start of treatment through the follow-up period.