China is a major liver cancer country, with 466,000 primary liver cancer incidences and 422,000 deaths in 2015. The number of incidence exceeds half of the total number of primary liver cancer incidence in the world. The mortality rate of liver cancer ranks second among all cancers in China. The effect of chemotherapy on liver cancer is extremely limited, and the only targeted drug available in the previous 10 years or so was doxorubicin (sorafenib). However, this year, the FDA approved regifinib as a second-line targeted drug for liver cancer. Meanwhile, other drugs such as levatinib and immunotherapy have published very encouraging clinical trial results for liver cancer this year. Chemotherapy is the use of drugs to destroy cancer cells. Systemic (systemic) chemotherapy refers to the use of anti-cancer drugs by injection intravenously or orally. These drugs enter the bloodstream and reach all areas of the body, so this treatment may be useful for cancers that have spread to distant organs. However, liver cancer is resistant to most chemotherapy drugs. The drugs that are most effective as systemic chemotherapy in liver cancer are adriamycin (Adriamycin), 5-fluorouracil and cisplatin. But even these drugs shrink only a small percentage of the tumor, and remissions often don’t last long. Even in most studies, combination chemotherapy does not help patients live longer. TACE uses a combination of chemotherapy and embolization, a dual mechanism of action to achieve a synergistic anti-tumor effect. Embolic agents cause ischemia and local hypoxia in the treated tissues. Arterial perfusion of chemotherapeutic agents provides higher drug concentrations to the tumor and is better tolerated by patients than systemic chemotherapy. Hypoxia induces vascular endothelial growth factor (VEGF) secretion, leading to increased vascular permeability. Vascular leakage, as well as hypoxia-induced cell membrane dysfunction and blood flow stagnation, result in higher intracellular deposition of chemotherapeutic agents and more intrahepatic retention. These changes lead to a reduction in the entry of chemotherapeutic agents into the systemic circulation, resulting in fewer side effects and toxicity. Targeted drugs and standard chemotherapy drugs work differently. They often have different (and sometimes less serious) side effects. Like chemotherapy, these targeted drugs enter the bloodstream and reach all areas of the body, which makes them potentially useful for cancers that have spread to distant organs. Because standard chemotherapy is ineffective for most liver cancer patients, doctors are always looking for more targeted treatments. Currently approved by the FDA and included in the NCCN guidelines for the treatment of liver cancer are sorafenib (first-line treatment) and regrafinib (second-line treatment).