Immunotherapy for primary liver tumors has recently shown great promise, with HCC demonstrating a 20% durable response rate with programed cell death protein 1 (PD-1) blockade and improved RFS following adjuvant treatment with programed death-ligand 1 (PD-L1) and vascular endothelial growth factor (VEGF) inhibitors12–14 Relatively little is known about immune checkpoint blockade in FLC, and limited early stage trials show mixed results in a small number of patients15–19. This evidence concerns the gene VEGFA and hepatocellular carcinoma.