HCC patients are frequently diagnosed at an advanced stage with indication for systemic therapy.3 4 The current immune checkpoint inhibitor (ICI) based first-line treatment targets programmed death ligand (PD-L1) alone or in combination with vascular endothelial growth factor (VEGF)5 6 or cytotoxic T-lymphocyte antigen 4 (CTLA-4).7 The gene discussed is VEGFA; the disease is hepatocellular carcinoma.