CTLA4 and hepatocellular carcinoma: First-line combination therapies with immune checkpoint blockade (ICB), via anti-programmed death ligand 1 (PD-L1), together with anti-VEGF and antibodies for cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) have provided survival benefits in a subset of patients (5, 7–11), but response rates remain confined to less than 30% of cases, and median survival for patients with unresectable advanced HCC continues to be less than 2 years (5, 7–15).