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83 In the future, combining microbiome sequencing and immune profiling is expected to enable personalized microbial interventions, such as transplanting beneficial flora to sensitize HCC patients ineffective to ICI therapy, or customizing probiotic formulas regulating immune balance for autoimmune liver disease patients, truly realizing the immune therapy paradigm shift from targeting the liver to targeting the intestinal niche. In HCC patients, the treatment regimen of nivolumab combined with oral vancomycin and tadalafil led to changes in the gut microbiome, reduced secondary bile acids, and significant changes in peripheral blood monocyte subsets