Patients with HCC and MVI, including Vp4 (presence of a tumor thrombus in the main trunk and/or contralateral portal vein), show superior survival when treated with atezolizumab and bevacizumab (anti-VEGF) than with sorafenib [19,42]; however, there was no additional survival benefit in durvalumab and tremelimumab treatment compared to that in sorafenib treatment in a subgroup analysis of the HIMALAYA trial [35]. This evidence concerns the gene VEGFA and hepatocellular carcinoma.