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We read with interest the article of recent advances in clinical practice of hepatocellular carcinoma (HCC) treatment by Bruix et al in Gut. 1 In this review, the Barcelona Clinic Liver Cancer (BCLC) Group recommended sorafenib as the standard treatment for BCLC-C stage (advanced stage) HCC. However, application of sorafenib as first treatment for advanced HCC worldwide was low according to a multiregional, large-scale, longitudinal cohort study.2 This may be attributed to some limitations of sorafenib: low response rate, modest survival advantage, complex mechanism underlying acquired resistance and high-level heterogeneity of individual response.3 4 Recently, evidence from an individual patient data meta-analysis of phase III randomised controlled trial showed no improvement in overall survival attributable to sorafenib for HBV-related HCC.5 Therefore, more alternative strategies are highly required.6
Hepatic arterial infusion (HAI) chemotherapy (HAIC) attracted more attentions in recent years due to high response rates and …
NL, YL and YK contributed equally.
Contributors MZ, NL, YoL, and YK conceived and designed the study. NL, YoL, ZZ, LL, LZ, LM, YL, QX, TP, JW and XL collected the data. NL, YK, AL, PW and MZ analysed and interpreted the data. All authors were involved in the drafting, review and approval of the report and the decision to submit for publication.
Competing interests None declared.
Ethics approval The Ethical Review Committee of Sun Yat-sen University Cancer Center.
Provenance and peer review Not commissioned; externally peer reviewed.