AFP and hepatocellular carcinoma: ,6 This subtype is characterized by high tumor invasiveness and poor prognosis, indicating a highly malignant form of HCC, which is similarly classified in the molecular biological classifications of Hoshida et al.15and Boyault et al.16Ramucirumab, an anti-VEGFR2 antibody, has demonstrated efficacy in patients with HCC who have high serum AFP levels3; however, the mechanism by which it inhibits tumor progression in highly malignant HCC has not been fully elucidated.