Hepatocellular carcinoma (HCC) is a major threat to human health in China with high morbidity and mortality.Surgical resection and liver transplantation are the most promising treatments for HCC.The majority of patients,however,are not eligible for surgery due to advanced tumor,multifocal disease or poor liver reserve.1 Recently,transarterial chemoembolization (TACE) improved survival compared with best supportive care in two individual clinical trials.2 Sorafenib is a multikinase inhibitor that targets both tumor cell proliferation and angiogenesis.The current standard of practice is to treat BCLC stage B HCC with TACE alone and more advanced (BCLC stage C) HCC with sorafenib only.1However,TACE activates hypoxia-inducible factor (HIF)-1 responses to hypoxia,which may stimulate VEGF and promote angiogenesis.The observed angiogenesis is related to up-regulation of local angiogenic factors which in t promote tumor regrowth,increasing the risk of metastases and a poor outcome.