Although hepatic arterial infusion chemotherapy (HAIC) combined with tyrosine kinase inhibitors (TKIs) and programmed cell death protein 1 (PD-1) inhibitors shows activity in advanced HCC with PVTT, whether adding PD-1 inhibitors to HAIC plus TKIs improves outcomes specifically in VP4 PVTT remains unclear.<h4>Methods</h4>This single-center retrospective study enrolled consecutive treatment-naïve patients with advanced HCC and VP4 PVTT who received HAIC plus TKIs (dual therapy) or HAIC plus TKIs and PD-1 inhibitors (triple therapy) from January 2018 to July 2025. This evidence concerns the gene PDCD1 and hepatocellular carcinoma.