Sorafenib
Sorafenib (Nexavar) 400 mg (200 mg/tab, 2 tabs) po bid until progression or unacceptable toxicity

Approved by FDA on 11/16/2007 (link to FDA file).

Llovet JM et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008; 359:378 (link to the article). 

Cheng A et al. Randomized phase III trial of sorafenib versus placebo in Asian patients with advanced hepatocellular carcinoma. 2008 ASCO annual meeting. Abstract 4509 (link to the abstract). 

Abou-Alfa GK et al. Phase II study of sorafenib in patients with advanced hepatocellular carcinoma. J Clin Oncol 2006; 24:4293 (link to the article). 

5-FU + LV
5-FU 370 mg/m2/d iv d1-5
Leucovorin 200 mg/m2/d iv d1-5
Q4w

Porta, C et al. 5-Fluorouracil and d,l-leucovorin calcium are active to treat unresectable hepatocellular carcinoma patients: preliminary results of a phase II study. Oncology 1995; 52:487 (link to the article).

Capecitabine
Capecitabine (Xeloda) 1000 mg/m2 po bid x 14 days
Q3w

Patt, YZ et al. Oral capecitabine for the treatment of hepatocellular carcinoma, cholangiocarcinoma, and gallbladder carcinoma. Cancer 2004; 101:578 (link to the article).

Capecitabine + Oxaliplatin (XELOX)
Capecitabine (Xeloda) 1000 mg/m2 po bid d1-14
Oxaliplatin (Eloxatin) 130 mg/m2 iv d1
Q3w

Boige V et al. Multicentre phase II trial of capecitabine plus oxaliplatin (XELOX) in patients with advanced hepatocellular cancinoma: FFCD 03-03 trial. Br J Cancer 2007; 97:862 (link to the article).  

Doxorubicin
Doxorubicin (Adriamycin) 60-75 mg/m2 iv
Q3w

Gish RG et al. Phase III randomized controlled trial comparing the survival of patients with unresectable hepatocellular carcinoma treated with nolatrexed or doxorubicin. J Clin Oncol 2007; 25:3069 (link to the article). 

Lai, CL et al. Doxorubicin versus no antitumor therapy in inoperable hepatocellular carcinoma. A prospective randomized trial. Cancer 1988; 62:479 (link to the article).

Cisplatin + Gemcitabine
Cisplatin (CDDP) 35 mg/m2 iv d1, 8
Gemcitabine (Gemzar) 1250 mg/m2 iv d1, 8
Q3w

Yang, TS et al. A phase II study of gemcitabine and cisplatin for patients with advanced hepatocellular carcinoma (abstract). 2003 ASCO annual meeting. Abstract 1351 (link to the article).

Bevacizumab
Bevacizumab (Avastin) 5 mg/kg or 10 mg/kg iv q2w until progression or unacceptable toxicity

Siegel AB et al. Phase II trial evaluating the clinical and biological effects of becacizumab in unresectable hepatocellular carcinoma. J Clin Oncol 2008; 26:2992 (link to the article). 

Gemcitabine + Oxaliplatin + Bevacizumab (GEMOX-B)
Cycle 1 (14 days)
Bevacizumab (Avastin) 10 mg/kg iv d1
Cycle 2 and beyond
Bevacizumab (Avastin) 10mg/kg iv d1, 15
Gemcitabine (Gemzar) 1000 mg/m2 iv at 10 mg/m2/min d2, 16
Oxaliplatin (Eloxatin) 85 mg/m2 iv over 2 hours d2, 16
Q4w

Zhu AX et al. Phase II study of gemcitabine and oxaliplatin in combination with bevacizumab in patients with advanced hepatocellular carcinoma. J Clin Oncol 2006; 24:1898 (link to the article).