In a phase 2 study (NCT01246986) with galunisertib (an inhibitor of the transforming growth factor beta, TGF-β) as a second-line treatment for patients with advanced HCC, Giannelli et al. demonstrated an association between a decrease in AFP and TGF-β1 circulating levels and an increase in OS. This evidence concerns the gene TGFB1 and hepatocellular carcinoma.