The first-line treatment for unresectable hepatocellular carcinoma patients: lenvatinib versus sorafenib, or beyond?

In the past decade, sorafenib has been the only approved molecular-targeted agent for unresectable hepatocellular carcinoma (uHCC) without any authentic challenges. There has been an urging need for alternatives or superior options for a long while (1,2). At least 25 molecular-targeted drugs emerged in the past 15 years and had been tested for the efficacy and safety in treating uHCC, yet most of those trials have failed to show positive results (Table 1).