However, treatment that is deemed a TACE failure or refractory is when (1) the tumor lacks objective response post-treatment with > 50% viable disease after two TACE sessions; (2) new HCC has developed within the area of treatment zone after two TACE sessions; (3) AFP has not shown improvement despite two TACE sessions; and (4) there is progression of HCC with advancement of HCC staging, such as with vascular invasion or extrahepatic metastases [17]. This evidence concerns the gene AFP and hepatocellular carcinoma.