PD-L1 positive status did not correlate with response in this study [37] The FDA subsequently granted approval for the use of pembrolizumab in second-line treatment of advanced HCC following the results of the phase II KEYNOTE 224 study where 104 patients who were intolerant of or had progressed on sorafenib were given 3 weekly pembrolizumab [38] In this study the response rate was 17% and the 12 month overall survival rate was 54% [38] Tremelimumab (anti-CTLA-4 antibody) has also proven efficacious in patients with advanced HCC due to chronic hepatitis C infection (Table 1). Here, CTLA4 is linked to hepatocellular carcinoma.