Ramucirumab as a second-line treatment for hepatocellular carcinoma: reaching out further to patients with elevated alpha-fetoprotein

Hepatocellular carcinoma (HCC) occurs at a rate of 3–5% per year in patients with compensated cirrhosis, and it often represents the first disease complication and the main cause of death in these patients (1). Surveillance for HCC is recommended by all liver disease associations, as it increases patient survival mainly as a result of early diagnosis of the tumour, allowing most patients to convey to curative treatments (2,3).