Inclusion Criteria:  Age ≥18 years Child-Pugh score≤ 7 HCC diagnosed by biopsy or by the noninvasive criteria of the Chinese Liver Cancer Guideline 2019 the primary HCC being in BCLC C stage according to NCCN guideline No previous systemic therapy for HCC  Exclusion Criteria:  Diffuse HCC Uncontrolled ascites of hepatic encephalopathy Prior liver transplantation Positive for human immunodeficiency virus Active gastric or duodenal ulcer Other uncontrolled comorbidities or malignancy