A patient who exceeded the up-to-seven criteria is susceptible to TACE refractoriness or to become to Child–Pugh class B. In such cases, lenvatinib is expected to (1) induce tumor necrosis and achieve downstaging, (2) inhibit recurrence by suppressing the release of hypoxia-inducing VEGF as a result of TACE, and (3) normalize the tumor vessels to enhance the effect of TACE when administered before TACE. This evidence concerns the gene VEGFA and neoplasm.