Table 4.

Systemic therapies approved for HCC by FDA

Agent	Mechanism	FDA-approved indications
First-line
Sorafenib	Targeting VEGFR, PDGFR, c-KIT, RET, and Ras/Raf/MEK/ERK	As monotherapy in patients with unresectable or metastasis HCC
Lenvatinib	Targeting VEGFR, PDGFR, FGFR, RET, and SCFR	As monotherapy in patients with unresectable HCC
Atezolizumab + Bevacizumab	Anti-PD-L1 antibody + Anti-VEGF antibody	For patients with unresectable or metastatic HCC who have not received prior systemic therapy
Second-line
Regorafenib	Targeting VEGFR, PDGFR, BRAF, FGFR, KIT, and RET	As monotherapy in sorafenib-experienced patients
Cabozantinib	Targeting VEGFR2, c-MET, AXL, KIT, and RET	As monotherapy in sorafenib-experienced patients
Ramucirumab	Anti-VEGFR antibody	As monotherapy in sorafenib-experienced patients with AFP of 400 ng/ml or higher
Nivolumab	Anti-PD-1 antibody	As monotherapy in sorafenib-experienced patients
Pembrolizumab Nivolumab + Ipilimumab	Anti-PD-1 antibody Anti-PD-1 antibody + Anti-CTLA-4 antibody	As monotherapy in sorafenib-experienced patients As combination therapy in sorafenib-experienced patients