Transcatheter arterial therapies for hepatocellular carcinoma (HCC) have 
developed during the last decade. A fine powder formulation of cisplatin and the 
new platinum agent miriplatin became standard medicines in addition to 
anthracyclines in transcatheter arterial chemoembolization (TACE) in Japan. 
Recent prospective and retrospective studies supported the usefulness of 
platinum agents as a chemotherapeutic at the time of varied TACE therapy. 
Although balloon-occluded TACE is an effective therapy for localized HCC and 
drug-eluting microspheres seemed to show a higher response rate in certain HCCs, 
the definite advantages of those procedures still remain uncertain. Intermediate 
stage HCC, or Barcelona Clinic Liver Cancer stage B, is regarded as a 
heterogeneous category with a wide spectrum of tumors and patients, and several 
subclassifications of the stage have been proposed to show different prognoses; 
there are also different recommended therapies in each subgroup. Authors have 
subclassified patients based on combinations of tumor size, tumor number, and 
liver function, with or without performance status. Because of differences of 
available medical resources and techniques in treatment procedures between 
countries, the most ideal and useful subgrouping remains inconclusive at 
present. Recently, a few systemic chemotherapies proved to be effective for 
advanced stage HCC in phase III studies: lenvatinib as the first line of 
therapy, and regorafenib, cabozantinib, and ramucirumab as second-line therapy. 
Other molecular-targeted and immune-oncological medicines are expected to follow 
in the near future. Some studies have suggested an advantage of early 
introduction of molecular-targeted therapy for TACE-resistant HCC in the 
intermediate stage.