Cohort 4 of the Checkmate-040 was designed to test the efficacy of varying doses of combination therapy of the CTLA-4 inhibitor, ipilimumab, and nivolumab in patients with advanced stage HCC following progression on sorafenib (arm A: nivolumab 1 mg/kg + ipilimumab 3 mg/kg, arm B: nivolumab 3 mg/kg + ipilimumab 1 mg/kg every 3 weeks for 4 doses followed by nivolumab maintenance (240 mg flat dose every 2 weeks), arm C: nivolumab 3 mg/kg + ipilimumab 1 mg/kg every 6 weeks until discontinuation due to progression or toxicity) (31). This evidence concerns the gene CTLA4 and hepatocellular carcinoma.